Kathy Johnson, LBSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6802068270 Issued in MI

Practice address

715 Pyle Dr
Kingsford, MI 49802-4456

Phone

(906) 774-0522

Fax

(906) 774-1570

NPI assigned

Aug 13, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kathy Opolka Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780696930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 PYLE DR",
            "city": "KINGSFORD",
            "state": "MI",
            "postal_code": "498024456",
            "telephone_number": "906-774-0522",
            "fax_number": "906-774-1570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 PYLE DR",
            "city": "KINGSFORD",
            "state": "MI",
            "postal_code": "498024456",
            "telephone_number": "906-774-0522",
            "fax_number": "906-774-1570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KATHY",
        "credential": "LBSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6802068270",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MICHIGAN",
            "identifier": "KJ068270",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHY",
            "last_name": "OPOLKA",
            "credential": "LBSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Social Worker in Kingsford, MI
• Providers in Kingsford, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.