Mrs Andra D Johnson, LISW, LCSW, LCAC is a
Social Worker - Clinical based in Fort Wayne, Indiana. Mrs Andra D Johnson is licensed to practice in Indiana (license number 34005636A (LCSW)) and her current practice location is
4656 W Jefferson Blvd, Suite 285, Fort Wayne, Indiana. She can be reached at her office (for appointments etc.) via phone at
(260) 422-9372.
NPI number for Mrs Andra D Johnson is 1093787426 and her current mailing address is 11014 Constantia Cv, Roanoke, Indiana. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1093787426.
Healthcare Provider's Profile
| Full Name | Mrs Andra D Johnson |
|---|
| Gender | Female |
|---|
| Speciality | Social Worker - Clinical |
|---|
| Location | 4656 W Jefferson Blvd, Fort Wayne, Indiana |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1093787426
- Provider Enumeration Date: 02/01/2006
- Last Update Date: 10/17/2011
Medical Identifiers
Medical identifiers for Mrs Andra D Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1093787426 | NPI | - | NPPES |
| 39628200 -31/078 | Medicaid | WI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 991842 (LICDC) (Ohio) | Secondary |
| 1041C0700X | Social Worker - Clinical | I - 0009358 (LISW) (Ohio) | Secondary |
| 1041C0700X | Social Worker - Clinical | 2979-123 (LCSW) (Wisconsin) | Secondary |
| 1041C0700X | Social Worker - Clinical | 34005636A (LCSW) (Indiana) | Primary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 87000438A (LCAC) (Indiana) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Andra D Johnson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mrs Andra D Johnson, LISW, LCSW, LCAC
11014 Constantia Cv,
Roanoke, IN 46783-8910
Ph: (216) 798-1997 | Mrs Andra D Johnson, LISW, LCSW, LCAC
4656 W Jefferson Blvd, Suite 285,
Fort Wayne, IN 46804-6857
Ph: (260) 422-9372 |
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