Active NPIIndividual provider

Ms. Stephanie A Johnson, LICSW

Social Worker, Clinical in Revere, Massachusetts

NPI Number1700902103
Practice location
300 Ocean Ave, Revere, MA 02151-3675
Fax
—
Last updated
March 5, 2012

Stephanie Ann Johnson is a Social Worker, Clinical based in Revere, MA. Stephanie Ann Johnson practices in Revere, MA and has the professional credentials of LICSW. The NPI Number for Stephanie Ann Johnson is 1700902103 and holds a License No. 112048 (MA). The current practice location address for Stephanie Ann Johnson is 300 Ocean Ave, Revere, MA 02151-3675 and can be reached out via phone at 781-485-6100.

Provider Profile Details

NPI Number
1700902103
Provider Name
Stephanie Ann Johnson
Credential
LICSW
Provider Entity Type
Individual
Gender
Female
Address
300 Ocean Ave, Revere, MA 02151-3675
Phone Number
781-485-6100
Primary Taxonomy
Social Worker, Clinical · 1041C0700X
Sole Proprietor
No
Provider Enumeration Date
March 21, 2007
Last Update Date
March 5, 2012
NPI Status
Active

Provider Business Practice Location Address Details

Address
300 Ocean Ave
Revere, MA 02151-3675
City
Revere
Zip
02151-3675
Phone Number
781-485-6100
Revere, MA 02151Get directions →

Provider Business Mailing Address Details

Address
200 Leisure Ln
Apartment #80
Stoneham, MA 02180-4003
City
Stoneham
State
MA
Zip
02180-4003
Phone Number
781-724-4275

License Information

License Number
112048
License State
MA
Taxonomy
Social Worker, Clinical · 1041C0700X · Primary

Legacy Identifiers

IdentifierTypeStateIssuer
No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider.

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Frequently Asked Questions

What is the NPI number of Ms. Stephanie A Johnson, LICSW?

The NPI number of Ms. Stephanie A Johnson, LICSW is 1700902103. It was assigned on March 21, 2007 and is currently active in the NPPES registry.

What is the specialty of Ms. Stephanie A Johnson, LICSW?

Ms. Stephanie A Johnson, LICSW is registered under the primary taxonomy Social Worker, Clinical (code 1041C0700X), licensed in MA under license number 112048.

Where does Ms. Stephanie A Johnson, LICSW practice?

The practice location is 300 Ocean Ave, Revere, MA 02151-3675. The office can be reached at 781-485-6100 (phone).

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.

How do I verify this NPI record?

This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1700902103 directly on the NPPES registry website.

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