Nicole Johnson, LMSW
Individual provider Active NPI Social Worker · Glenmora, LA
NPI 1821697616 · NPPES record last updated Aug 4, 2022
Key facts
- NPI
- 1821697616
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 15492 (LA)
- Practice address
- 1414 7TH Avenue
Glenmora, LA 71433 - Phone
- (318) 748-8145
- NPI assigned
- Oct 22, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15492 | LA | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Access Health Louisiana | Past |
Accepting new patients | |
| Access Health Louisiana | Past | Accepting new patients |
Interoperability endpoints
- nicole.johnson.1@11331.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 15492 | LA | Yes |
Addresses
Primary practice location
1414 7TH Avenue
Glenmora, LA 71433
Mailing address
35 Redmond Loop
Glenmora, LA 71433-4840
Phone (318) 791-6226
Other providers in Glenmora, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 4, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.