Abigale Johnson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

089556 Issued in NY

Practice address

300 Main St Ste 65
Madison, NJ 07940-2369

Phone

(646) 543-1507

NPI assigned

May 21, 2016

Last updated

Dec 9, 2022By the provider in NPPES

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

• Abigale Wallace Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
• FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Boundary Nyc LLC

  dba The Boundary

  • Clinical Social Worker
  • Madison, NJ
  • NPI 1619689692
  NPD Authorized official
• The New York and Presbyterian Hospital

  dba NewYork-Presbyterian Hospital

  • General Acute Care Hospital
  • New York, NY
  • NPI 1194832477
  NPD (past)

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

{
    "created_epoch": "1463788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670544000000",
    "number": "1972950764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 LISA DR",
            "city": "CHATHAM",
            "state": "NJ",
            "postal_code": "079281035",
            "telephone_number": "646-543-1507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MAIN ST STE 65",
            "city": "MADISON",
            "state": "NJ",
            "postal_code": "079402369",
            "telephone_number": "646-543-1507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ABIGALE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-21",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "089556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ABIGALE",
            "last_name": "WALLACE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jessica Lila Ivan, RRT
• Yanderi Jimenez Restituyo, ATC, LAT
• JLC Consulting LLC
• Elizabeth Redegeld Johannes, PH.D., LCSW
• Alexis Aliyha Johnson-Maxim, NP-C
• Marc J Joseph
• Joshi Dental, LLC
• Nimish Bharat Joshi, DMD
• Christopher Jovino
• Renee F Joyce, LCSW

• Clinical Social Worker in Madison, NJ
• Providers in Madison, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2022; 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.