Jessica Kimberley Johnson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L4577 Issued in OR

Practice address

1002 Library CT
Oregon City, OR 97045-4066

Phone

(503) 655-8264

Fax

(503) 655-8428

NPI assigned

Jun 4, 2010

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 names 1

• Jessica Kimberley Staples Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Clackamas County

  • Federally Qualified Health Center (FQHC)
  • Clackamas, OR
  • NPI 1891042487
  NPD (past)
• County of Clackamas Office of County Auditor

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Milwaukie, OR
  • NPI 1245269315
  NPD (past)

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

{
    "created_epoch": "1275609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348617600000",
    "number": "1962722561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2051 KAEN RD",
            "address_2": "SUITE 367",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970454035",
            "telephone_number": "503-742-5300",
            "fax_number": "503-655-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 LIBRARY CT",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970454066",
            "telephone_number": "503-655-8264",
            "fax_number": "503-655-8428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JESSICA",
        "middle_name": "KIMBERLEY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-04",
        "last_updated": "2012-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L4577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "STAPLES",
            "middle_name": "KIMBERLEY",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Anthony Johnson
• Brett Larkin Johnson, DMD
• Cindi Johnson, MOTR/L
• Curtis Johnson, LCSW
• Harold Desmond Johnson, MEDICAL DOCTOR
• Jordan Johnson, MD
• Kaitlyn Johnson, LMT
• Kevin Raymond Johnson I, M.D.
• La'Kim Denise Johnson
• William Russell Johnson Jr.

• Clinical Social Worker in Oregon City, OR
• Providers in Oregon City, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2012; 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.