Individual provider Active NPI

Nancy G. Johnson, LCSW SAC

  • Clinical Social Worker
  • Blanchardville, WI
National Provider Identifier
1922579655
Registry record updated Dec 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7310-123 Issued in WI
Practice address
305 County Rd. K
Blanchardville, WI 53516
Phone
(608) 295-6432
NPI assigned
Dec 6, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 7310-123 WI Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 125-131 WI

Addresses

Primary practice location

305 County Rd. K
Blanchardville, WI 53516

Mailing address

305 County Rd. K
Blanchardville, WI 53516
Phone (608) 295-6432

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
125-131WIMDAddiction (Substance Use Disorder) Counselor
7310-123WIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1544054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544054400000",
    "number": "1922579655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 COUNTY RD. K",
            "city": "BLANCHARDVILLE",
            "state": "WI",
            "postal_code": "53516",
            "telephone_number": "608-295-6432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 COUNTY RD. K",
            "city": "BLANCHARDVILLE",
            "state": "WI",
            "postal_code": "53516",
            "telephone_number": "608-295-6432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "NANCY",
        "middle_name": "G.",
        "name_prefix": "Mrs.",
        "credential": "LCSW SAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-06",
        "last_updated": "2018-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7310-123",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "125-131",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blanchardville, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2018; 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.