Individual provider Active NPI

Conncetta B Johnson, SOCIAL WORKER LMSW

  • Social Worker
  • Bronx, NY
National Provider Identifier
1871747014
Registry record updated Nov 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
048788-1 Issued in NY
Practice address
1212 Ogden Ave # 2
Bronx, NY 10452-3541
Phone
(646) 391-4544
Fax
(718) 299-7801
NPI assigned
Nov 14, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 048788-1 NY Primary

Addresses

Primary practice location

1212 Ogden Ave # 2
Bronx, NY 10452-3541

Mailing address

1212 Ogden Ave
Bronx, NY 10452-3541
Phone (646) 391-4544

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
048788-1NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
CTJ Touch of Love. Inc Past Accepting new patients

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": "1226620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226620800000",
    "number": "1871747014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 OGDEN AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104523541",
            "telephone_number": "646-391-4544",
            "fax_number": "718-299-7801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 OGDEN AVE # 2",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104523541",
            "telephone_number": "646-391-4544",
            "fax_number": "718-299-7801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CONNCETTA",
        "middle_name": "B",
        "name_prefix": "Miss",
        "credential": "SOCIAL WORKER LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-14",
        "last_updated": "2008-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "048788-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2008; 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.