Individual provider Active NPI

Anna Johnson, LCSW

  • Clinical Social Worker
  • Essex, CT
National Provider Identifier
1881135358
Registry record updated Mar 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
004233 Issued in CT
Practice address
158 Westbrook Rd
Suite 7
Essex, CT 06426-1553
Phone
(860) 575-1671
Fax
(866) 706-1701
NPI assigned
Mar 16, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 004233 CT Primary

Addresses

Primary practice location

158 Westbrook Rd
Suite 7
Essex, CT 06426-1553

Mailing address

20 Waterhouse LN
Chester, CT 06412-1268
Phone (860) 964-3667

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20171004002636 CT Practitioner - Clinical Social Worker 8022383843 Reassigns benefits to 1 organization
Practice locations: Old Saybrook, CT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

954 Middlesex Tpke
Unit 1
Old Saybrook, CT 06475-1302
Phone (860) 964-3667

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004233CTMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Counseling Center LLC CurrentSince Oct 5, 2017 Accepting new patients

Locations

16 Saybrook Rd
Essex, CT 06426
Phone (860) 575-1671

158 Westbrook Rd
Ste 7
Essex, CT 06426
Phone (860) 575-1671

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": "1489622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489622400000",
    "number": "1881135358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 WATERHOUSE LN",
            "city": "CHESTER",
            "state": "CT",
            "postal_code": "064121268",
            "telephone_number": "860-964-3667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 WESTBROOK RD",
            "address_2": "SUITE 7",
            "city": "ESSEX",
            "state": "CT",
            "postal_code": "064261553",
            "telephone_number": "860-575-1671",
            "fax_number": "866-706-1701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ANNA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-16",
        "last_updated": "2017-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "004233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Essex, CT

Sources for this page

Verify at the official NPI Registry.