Kelly Johnson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

19423 Issued in AZ

Practice address

18205 N 51St Ave Ste 109
Glendale, AZ 85308-1491

Phone

(623) 396-6216

NPI assigned

Feb 11, 2012

Last updated

Jun 12, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Clinical Social Worker

Education

Other, 2010

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Compass Mental Health, LLC

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  • Phoenix, AZ
  • NPI 1881737849
  NPD (past)
• Composs Mental Health

  • Community/Behavioral Health Agency
  • Phoenix, AZ
  • NPI 1316279680
  NPD (past)

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

{
    "created_epoch": "1328918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654992000000",
    "number": "1942573621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2527 W KIT CARSON TRL",
            "city": "ANTHEM",
            "state": "AZ",
            "postal_code": "850861877",
            "telephone_number": "623-396-6216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18205 N 51ST AVE STE 109",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853081491",
            "telephone_number": "623-396-6216"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13260 N 94th Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "AZ",
            "postal_code": "853814242",
            "country_code": "US",
            "telephone_number": "623-396-6216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KELLY",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-11",
        "last_updated": "2022-06-12",
        "certification_date": "2022-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "19423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dennis Allen Johnson, DMD
• Eric W Johnson, PSY.D.
• Erik Johnson, OTR/L
• Kaitlyn Johnson
• Katherine Johnson, PHARM D
• Kelly Elizabeth Johnson
• Kendi Johnson, RBT
• Kenra Earline Johnson, FNP-C
• Kjerstin Johnson
• Kwamaine Johnson

• Clinical Social Worker in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Clinical Social Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.