Individual provider Active NPI

Katherine Johnson, LCSW

  • Clinical Social Worker
  • Dalton, GA
National Provider Identifier
1962227272
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW009398 Issued in GA
Practice address
900 Shugart Rd
Dalton, GA 30720-2467
Phone
(706) 270-5107
Fax
(706) 270-5111
NPI assigned
Nov 21, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW009398 GA Primary

Addresses

Primary practice location

900 Shugart Rd
Dalton, GA 30720-2467

Mailing address

1503 N Tibbs Rd
Dalton, GA 30720-2915
Phone (706) 229-7332

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20241230002549 GA Practitioner - Clinical Social Worker 0042747230 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Alabama School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Highland Rivers Community Service BoardGroup PAC ID 9032000245, 57 clinicians

Practice addresses (Care Compare)

900 Shugart Rd
Suite B
Dalton, GA 30720-2467
Phone (706) 270-5027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW009398GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Highland Rivers Community Service Board CurrentSince Nov 18, 2024 Accepting new patients
Highland Rivers CSB CurrentSince Nov 18, 2024 Accepting new patients

Locations

191 Lamar Haley Pkwy
Canton, GA 30114
Phone (770) 704-1600

1503 N Tibbs Rd
Dalton, GA 30720
Phone (706) 229-4507

900 Shugart Rd
Ste B
Dalton, GA 30720
Phone (706) 270-5027

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1732147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1962227272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1503 N TIBBS RD",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202915",
            "telephone_number": "706-229-7332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 SHUGART RD",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202467",
            "telephone_number": "706-270-5107",
            "fax_number": "706-270-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KATHERINE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-21",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW009398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

Verify at the official NPI Registry.