Individual provider Active NPI

Susan Holyoke Johnston, MSW

  • Clinical Social Worker
  • Reston, VA
National Provider Identifier
1942412960
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904000078 Issued in VA
Practice address
11428 Waterview Cluster
Reston, VA 20190-4313
Phone
(703) 787-8066
NPI assigned
May 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904000078 VA Primary
Clinical Social Worker 1041C0700X 00204 MD
Clinical Social Worker 1041C0700X LC300496 DC

Addresses

Primary practice location

11428 Waterview Cluster
Reston, VA 20190-4313

Mailing address

11428 Waterview Cluster
Reston, VA 20190-4313
Phone (703) 787-8066

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
LC300496DCMDClinical Social Worker
00204MDMDClinical Social Worker
0904000078VAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942412960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11428 WATERVIEW CLUSTER",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201904313",
            "telephone_number": "703-787-8066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11428 WATERVIEW CLUSTER",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201904313",
            "telephone_number": "703-787-8066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "SUSAN",
        "middle_name": "HOLYOKE",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904000078",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "00204",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC300496",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.