Alicia A Johnson, LISW, ICDC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I-1600108 Issued in OH

Practice address

975 Kingsview Dr
BLDG a
Lebanon, OH 45036-9562

Phone

(513) 228-7800

Fax

(513) 228-7846

NPI assigned

Feb 19, 2014

Last updated

Apr 12, 2016By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Modern Psychiatry and Wellness LLCGroup PAC ID 6608029962, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/5507/brand/1/csg/1/fhir/r4
• FHIR API: https://api.qualifacts.org/api/fhir/mpwhealth/r4/

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.

• Modern Psychiatry and Wellness LLC

  • Adult Mental Health Clinic/Center
  • Hamilton, OH
  • NPI 1225260888
  Medicare reassignment Care Compare group NPD
• Modern Psychiatry & Wellness, LLC

  • Adult Mental Health Clinic/Center
  • Hamilton, OH
  • NPI 1699251553
  NPD

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

{
    "created_epoch": "1392768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460419200000",
    "number": "1952726556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 COOK RD",
            "address_2": "SUITE 400",
            "city": "LEBANON",
            "state": "OH",
            "postal_code": "450369600",
            "telephone_number": "513-228-7800",
            "fax_number": "513-695-2952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 KINGSVIEW DR",
            "address_2": "BLDG A",
            "city": "LEBANON",
            "state": "OH",
            "postal_code": "450369562",
            "telephone_number": "513-228-7800",
            "fax_number": "513-228-7846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ALICIA",
        "middle_name": "A",
        "credential": "LISW, ICDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-19",
        "last_updated": "2016-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "ICDC-151043",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I-1600108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Gay Jensen, P.T.
• Susan Dix Jividen, OT
• JM NP Telehealth LLC
• Jobar Companies (BrightStar Health Care)
• Angela D Johnsen, LISW-S
• Allison Johnson, P.T.
• Amy J Johnson
• Blaire Johnson, QMHP
• Dominique A Johnson
• Jennifer M Johnson

• Clinical Social Worker in Lebanon, OH
• Providers in Lebanon, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2016; 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.