Individual provider Active NPI

Amber Renee Johnson, LCSW, CASAC

  • Clinical Social Worker
  • Elmhurst, NY
National Provider Identifier
1891310769
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
109489 Issued in NY
Practice address
9131 Queens Blvd Ste 222
Elmhurst, NY 11373-5511
Phone
(718) 896-3400
NPI assigned
Jun 16, 2020
Last updated
Aug 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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 109489 NY Primary

Addresses

Primary practice location

9131 Queens Blvd Ste 222
Elmhurst, NY 11373-5511

Mailing address

9131 Queens Blvd Ste 222
Elmhurst, NY 11373-5511
Phone (718) 896-3400

Other names 1

  • Amber Renee Johnson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20240311002351 NY Practitioner - Clinical Social Worker 6204272420 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Doppler Psychology Services at Home PCGroup PAC ID 2062821713, 16 clinicians

Practice addresses (Care Compare)

4 Medical Park Dr
Suite B
Pomona, NY 10970-3572
Phone (516) 810-1290

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
109489NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Long Island Consultation Center, Inc. Clinical CurrentSince Jan 13, 2024 Accepting new patients
Long Island Consultation Center CurrentSince Aug 25, 2025 Accepting new patients
Doppler Psychology Services at Home PC CurrentSince Aug 1, 2025 Accepting new patients

Locations

9131 Queens Blvd
Ste 222
Elmhurst, NY 11373
Phone (718) 896-3400

4 Medical Park Dr
Ste B
Pomona, NY 10970
Phone (845) 354-3131

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/liccnewyorkcity/r4/

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1592265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1891310769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9131 QUEENS BLVD STE 222",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113735511",
            "telephone_number": "718-896-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9131 QUEENS BLVD STE 222",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113735511",
            "telephone_number": "718-896-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "AMBER",
        "middle_name": "RENEE",
        "credential": "LCSW, CASAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-16",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "109489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMBER",
            "last_name": "JOHNSON",
            "middle_name": "RENEE",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Elmhurst, NY

Sources for this page

Verify at the official NPI Registry.