Mary V. Johnson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3304 Issued in OR

Practice address

1221 Abrams Rd
236
Dallas, TX 75081-5578

Phone

(214) 604-7650

NPI assigned

Aug 13, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Vickie Johnson Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Assurasource LTD

  • Clinical Social Worker
  • Plano, TX
  • NPI 1194746016
  NPD (past)
• New Narrative

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tigard, OR
  • NPI 1265595664
  NPD (past)

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

{
    "created_epoch": "1218585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1962658658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 NW HARWOOD ST",
            "city": "PRINEVILLE",
            "state": "OR",
            "postal_code": "977541445",
            "telephone_number": "541-647-7707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 ABRAMS RD",
            "address_2": "236",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "750815578",
            "telephone_number": "214-604-7650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARY",
        "middle_name": "V.",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-13",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "3304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "3304",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICKIE",
            "last_name": "JOHNSON",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Marcus Lorenzo Johnson, D.C.
• Margie Jeanette Johnson, RRT
• Mark Johnson
• Mark Douglas Johnson, MD
• Marketa Johnson
• Matthew Johnson, CRNA
• Matthew James Johnson, D.P.M.
• McKenzie Johnson, RN
• McKinley Johnson
• Megan Johnson, M.ED., LPC, LCDC

• Clinical Social Worker in Dallas, TX
• Providers in Dallas, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; 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.