Active NPI
Ray Thomas Johnston, L.C.S.W., S.A.P.
- Clinical Social Worker
- Nacogdoches, TX
National Provider Identifier
1811026511
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 10482
- Practice address
- 207A Blount St
Nacogdoches, TX 75965-3541 - Phone
- (936) 569-8570
- Fax
- (936) 560-1144
- NPI assigned
- Mar 6, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 10482 | TX | Primary |
Addresses
Primary practice location
207A Blount St
Nacogdoches, TX 75965-3541
Mailing address
207A Blount St
Nacogdoches, TX 75965-3541
Phone (936) 569-8570
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 089263002 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10482 | TX | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1811026511",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "207A BLOUNT ST",
"city": "NACOGDOCHES",
"state": "TX",
"postal_code": "759653541",
"telephone_number": "936-569-8570",
"fax_number": "936-560-1144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "207A BLOUNT ST",
"city": "NACOGDOCHES",
"state": "TX",
"postal_code": "759653541",
"telephone_number": "936-569-8570",
"fax_number": "936-560-1144"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSTON",
"first_name": "RAY",
"middle_name": "THOMAS",
"credential": "L.C.S.W., S.A.P.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "10482",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "089263002",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Nacogdoches, TX
Sources for this page
- 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.