Rebecca Andra Johnson, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

120326 Issued in MA

Practice address

1 Administration Rd
Bridgewater, MA 02324-3230

Phone

(508) 279-6094

NPI assigned

Aug 27, 2018

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

Other names 1

• Ms. Rebecca Andra Penney Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1535328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1952882110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ADMINISTRATION RD",
            "city": "BRIDGEWATER",
            "state": "MA",
            "postal_code": "023243230",
            "telephone_number": "508-279-6094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ADMINISTRATION RD",
            "city": "BRIDGEWATER",
            "state": "MA",
            "postal_code": "023243230",
            "telephone_number": "508-279-6094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "REBECCA",
        "middle_name": "ANDRA",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-27",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "120326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "PENNEY",
            "middle_name": "ANDRA",
            "prefix": "MS.",
            "credential": "LCSW; LICSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lourdes N Irizarry Gonzalez, MPHE
• Brittany McKenzie Irwin, LICSW
• Stephanie Anne JN Michel Accime
• Brittany E Johnson, LMHC
• Iris Miranda Johnson
• Laura C Johnston, LADC1, LMHC
• Raspreet Kaur Kalra
• Kerri Ann Kane, PSY.D.
• Michaela Janet Louise Kane
• Brendan Keane

• Clinical Social Worker in Bridgewater, MA
• Providers in Bridgewater, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; 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.