Johnny Allen, MSW
Individual provider Active NPI Social Worker · Shiprock, NM
NPI 1962492355 · NPPES record last updated May 20, 2008
Key facts
- NPI
- 1962492355
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- M3754 (NM)
- Practice address
- US Hwy 491 North
Shiprock, NM 87420 - Phone
- (505) 368-6401
- Fax
- (505) 368-6431
- NPI assigned
- Oct 26, 2005
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | M3754 | NM | Yes |
Addresses
Primary practice location
US Hwy 491 North
Shiprock, NM 87420
Mailing address
PO Box 160
Shiprock, NM 87420-0160
Phone (505) 368-6401
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 69338558 | Medicaid | NM | |
| 24989053 | Medicaid | CO |
Other names
- Johnnie Allen
Other providers in Shiprock, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 20, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.