Anjuli Shah-Johnson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149012025 Issued in IL

Practice address

5014 NE 15TH Ave
Portland, OR 97211-4406

Phone

(773) 991-0103

NPI assigned

Jun 15, 2009

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Oct 1, 2023 through Oct 1, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Anjuli Shah-Johnson

  • Adolescent and Children Mental Health Clinic/Center
  • Portland, OR
  • NPI 1043677198
  NPD (past) Authorized official
• Sankofa Counseling, LLC

  • Professional Counselor
  • Portland, OR
  • NPI 1851842108
  NPD (past)

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

{
    "created_epoch": "1245024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1881821189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5014 NE 15TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972114406",
            "telephone_number": "773-991-0103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5014 NE 15TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972114406",
            "telephone_number": "773-991-0103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH-JOHNSON",
        "first_name": "ANJULI",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-15",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149012025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Willie Shaffer, CADC I,
• Zachary William Shaffer
• Adi Shafir, M.D.
• Leigh Michelle Shafir, PA
• Hadeel Shagroon
• Amit Rajni Shah, MD
• Amy J Shah, DO
• Anjali Shah, D.O.
• Anushi R Shah, MD
• Jignesh S Shah, M.D.

• Clinical Social Worker in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.