Minta Gardyn Johnson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

58540 Issued in TX

Practice address

1755 N Collins Blvd
Suite 525
Richardson, TX 75080-3562

Phone

(214) 369-5522

Fax

(214) 369-5327

NPI assigned

Sep 23, 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

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Senior Psychological Care Dallas I, LLC

  • Psychologist
  • Houston, TX
  • NPI 1649566795

  Clinical

  Medicare reassignment NPD
• Bent Tree Medicine, PLLC

  • Internal Medicine Physician
  • Plano, TX
  • NPI 1215430756
  NPD

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

{
    "created_epoch": "1222128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389052800000",
    "number": "1972753366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1755 N COLLINS BLVD",
            "address_2": "SUITE 525",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750803562",
            "telephone_number": "214-369-5522",
            "fax_number": "214-369-5327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 N COLLINS BLVD",
            "address_2": "SUITE 525",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750803562",
            "telephone_number": "214-369-5522",
            "fax_number": "214-369-5327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MINTA",
        "middle_name": "GARDYN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-23",
        "last_updated": "2014-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "58540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Johnson
• Julia Johnson, CCC SLP
• Justin Blake Johnson, DC
• Kimberly Mary Johnson
• Lane Johnson, MS LPC
• Monetta Ruth Johnson
• Patricia Norton Johnson, M.S., L.P.C.
• Sara Johnson
• Sheila Johnson
• Tanya Lyn Johnson, MS, CCC-SLP

• Clinical Social Worker in Richardson, TX
• Providers in Richardson, 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 Jan 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.