Active NPI
Donna Johanson LCSW LLC
- Clinical Social Worker
- Sherman, CT
National Provider Identifier
1922491463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 008353
- Legal business name
- DONNA JOHANSON LCSW LLC
- Practice address
- 40 Spring Lake Rd
Sherman, CT 06784-1200 - Phone
- (860) 729-4631
- Fax
- (888) 972-5017
- NPI assigned
- Mar 9, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Donna Johanson, LCSW
- Title
- Provider
- Phone
- (860) 729-4631
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 008353 | CT | Primary |
Addresses
Primary practice location
40 Spring Lake Rd
Sherman, CT 06784-1200
Mailing address
40 Spring Lake Rd
Sherman, CT 06784-1200
Phone (860) 729-4631
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150610000403 | CT | Part B Supplier - Clinic/Group Practice | 1658692066 |
Receives reassigned benefits from 1 practitioner Practice locations: Sherman, CT |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 9
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1425859200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1425859200000",
"number": "1922491463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 SPRING LAKE RD",
"city": "SHERMAN",
"state": "CT",
"postal_code": "067841200",
"telephone_number": "860-729-4631",
"fax_number": "888-972-5017"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 SPRING LAKE RD",
"city": "SHERMAN",
"state": "CT",
"postal_code": "067841200",
"telephone_number": "860-729-4631",
"fax_number": "888-972-5017"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DONNA JOHANSON LCSW LLC",
"organizational_subpart": "NO",
"enumeration_date": "2015-03-09",
"last_updated": "2015-03-09",
"status": "A",
"authorized_official_last_name": "JOHANSON",
"authorized_official_first_name": "DONNA",
"authorized_official_title_or_position": "PROVIDER",
"authorized_official_telephone_number": "860-729-4631",
"authorized_official_credential": "LCSW"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "008353",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sherman, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.