Johnnie L Smith-Shull, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1513 Issued in NH

Practice address

85 Mechanic St Ste 3B-1
Dartmouth Hitchcock - Psychiatry
Lebanon, NH 03766-1537

Phone

(603) 653-1732

NPI assigned

Feb 21, 2007

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480982400000",
    "number": "1962547422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 MECHANIC ST STE 3B-1",
            "address_2": "DARTMOUTH HITCHCOCK - PSYCHIATRY",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037661537",
            "telephone_number": "603-653-1732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 MECHANIC ST STE 3B-1",
            "address_2": "DARTMOUTH HITCHCOCK - PSYCHIATRY",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037661537",
            "telephone_number": "603-653-1732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH-SHULL",
        "first_name": "JOHNNIE",
        "middle_name": "L",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2016-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW00005924",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "1513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Skogsholm, MD
• Catherine Christina Slay, PTA
• Bruce Todd Sloan, PA
• Kathleen M Sloop, CRNA
• Vanessa B Smist, PA
• Andrew J Smith, PHD
• Christian Taylor Smith, MD
• Ellen M Smith, PH(C), MS, APRN-BC
• Jean M Smith, OTR/L
• Karen Griffiths Smith

• Clinical Social Worker in Lebanon, NH
• Providers in Lebanon, NH by specialty
• Clinical Social Worker in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2016; 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.