Individual provider Active NPI

Denise Lasal Johnson, LGSW

  • Clinical Social Worker
  • Aberdeen, MD
National Provider Identifier
1760678486
Registry record updated Sep 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
G12941 Issued in MD
Practice address
135 N Parke St
Aberdeen, MD 21001-2428
Phone
(443) 625-1600
Fax
(443) 625-1520
NPI assigned
Sep 17, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X G12941 MD Primary

Addresses

Primary practice location

135 N Parke St
Aberdeen, MD 21001-2428

Mailing address

515 Warren St
Apt. 2
Havre de Grace, MD 21078-2662
Phone (410) 939-1808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101012000762 MD Practitioner - Clinical Social Worker 9638361413 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
G12941MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Oic Counseling Services, Inc. CurrentSince Oct 1, 2012 Accepting new patients

Locations

336 S Main St
Ste 1C
Bel Air, MD 21014
Phone (410) 836-0820

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1189987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189987200000",
    "number": "1760678486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 WARREN ST",
            "address_2": "APT. 2",
            "city": "HAVRE DE GRACE",
            "state": "MD",
            "postal_code": "210782662",
            "telephone_number": "410-939-1808",
            "fax_number": "443-625-1520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 N PARKE ST",
            "city": "ABERDEEN",
            "state": "MD",
            "postal_code": "210012428",
            "telephone_number": "443-625-1600",
            "fax_number": "443-625-1520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DENISE",
        "middle_name": "LASAL",
        "name_prefix": "Miss",
        "credential": "LGSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-17",
        "last_updated": "2007-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "G12941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aberdeen, MD

Sources for this page

Verify at the official NPI Registry.