Individual provider Active NPI

Theresa Johns, LCSW

  • Clinical Social Worker
  • Bardstown, KY
National Provider Identifier
1902845241
Registry record updated Jun 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
252030 Issued in KY
Practice address
331 S 3Rd St
Bardstown, KY 40004-1032
Phone
(502) 348-9206
Fax
(502) 348-6485
NPI assigned
Jun 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 4672 KY
Clinical Social Worker 1041C0700X 252030 KY Primary

Addresses

Primary practice location

331 S 3Rd St
Bardstown, KY 40004-1032

Mailing address

107 Cranes Roost CT
Elizabethtown, KY 42701-3650
Phone (270) 765-2605

Other identifiers 2

IdentifierTypeStateIssuer
000000339368OtherKYANTHEM
30605018MedicaidKY

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
4672KYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
US Psychiatry PLLC PastSince May 14, 2018 Accepting new patients
Communicare Inc Past Accepting new patients

Organizations & group practices 2

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": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467158400000",
    "number": "1902845241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 CRANES ROOST CT",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427013650",
            "telephone_number": "270-765-2605",
            "fax_number": "270-234-8572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 S 3RD ST",
            "city": "BARDSTOWN",
            "state": "KY",
            "postal_code": "400041032",
            "telephone_number": "502-348-9206",
            "fax_number": "502-348-6485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNS",
        "first_name": "THERESA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2016-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KY",
            "license": "4672",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "252030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000339368",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30605018",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bardstown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2016; 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.