Individual provider Active NPI

Jody A. Johnson, LCSW

  • Clinical Social Worker
  • Grand Island, NE
National Provider Identifier
1760680797
Registry record updated Mar 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1338 Issued in NE
Practice address
308 N Locust St
Grand Island, NE 68801-5969
Phone
(402) 225-6360
NPI assigned
Jul 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2026

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 8325 NE
Clinical Social Worker 1041C0700X 1338 NE Primary
Clinical Social Worker 1041C0700X 2166 NE
Clinical Social Worker 1041C0700X 111283 IA
Mental Health Counselor 101YM0800X 1238 NE
Mental Health Counselor 101YM0800X 111283 IA

Addresses

Primary practice location

308 N Locust St
Grand Island, NE 68801-5969

Mailing address

308 N Locust St
Grand Island, NE 68801-5969
Phone (402) 225-6360

Other practice location 1

2608 Old Fair Rd
Grand Island, NE 68803-5271
Phone (308) 382-5297 ext. 10

Other identifiers 1

IdentifierTypeStateIssuer
10025173100MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20070731000418 NE Practitioner - Clinical Social Worker 6204937584 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

308 N Locust St
Suite 401
Grand Island, NE 68801-5901
Phone (402) 225-6360

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8325NEMDMental Health Counselor
111283IAMDClinical Social Worker
1238NEMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Specialty Group PA Mental Health CurrentSince Mar 25, 2025 Accepting new patients
Lifespan Therapy, LLC Clinical CurrentSince Dec 22, 2020 Accepting new patients
Wholeness Healing Center PC Mental Health CurrentSince Aug 3, 2007 Accepting new patients

Locations

2608 Old Fair Rd
Grand Island, NE 68803
Phone (308) 382-5297

308 N Locust St
Ste 401
Grand Island, NE 68801
Phone (402) 225-6360

Organizations & group practices 3

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": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773273600000",
    "number": "1760680797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 N LOCUST ST",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688015969",
            "telephone_number": "402-225-6360",
            "fax_number": "402-988-1565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 N LOCUST ST",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688015969",
            "telephone_number": "402-225-6360"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2608 Old Fair Rd",
            "address_purpose": "LOCATION",
            "city": "Grand Island",
            "state": "NE",
            "postal_code": "688035271",
            "country_code": "US",
            "telephone_number": "308-382-5297 x10",
            "fax_number": "308-382-5315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JODY",
        "middle_name": "A.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-11",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "8325",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "1338",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "2166",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "111283",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "1238",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "111283",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025173100",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NE

Sources for this page

Verify at the official NPI Registry.