MR. KENDALL M JOHNSON (NPI# 1073659298) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073659298 |
| Entity Type | Individual |
| Full Name | MR. KENDALL M JOHNSON |
| Credential | L.C.S.W. |
| Practice Address |
9155 Sw Barnes Rd Ste 333 Portland OR 97225-6630 |
| Mailing Address |
Po Box 3158 Portland OR 97208-3158 |
| Practice Telephone | 5032165102 |
| Mailing Telephone | 5032156494 |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2020-03-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 104100000X | Social Worker | L5441 | OR | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
L5441 | Behavioral Health & Social Service Providers | |
| N | 1041C0700X |
Social Worker Specialization: Clinical |
075642 | NY | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 9450 Sw Barnes Rd, Suite 200, Portland, OR 972256619 | 5032165016 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962785212 | Kendall Amanda Johnson | Physician Assistant | 5065 Pyramid Hwy, Sparks, NV 89436-7703 | 2011-09-22 |
| 1982856308 | Kendall Odell Johnson | Physical Therapist | 1024 Beech Tree Ln, Brentwood, TN 37027-7642 | 2008-10-16 |
| 1205331352 | Kendall Rae Johnson | Student in an Organized Health Care Education/Training Program | 2623 S Seacrest Blvd, Boynton Beach, FL 33435-7501 | 2018-03-29 |
| 1972985091 | Kendall Johnson | Family Medicine | 2700 Clay Edwards Dr Ste 240, North Kansas City, MO 64116-3254 | 2015-06-25 |
| 1932452422 | Kendall Johnson | Specialist | 4647 N 32nd St, Suite 185, Phoenix, AZ 85018-3345 | 2012-10-21 |
| 1316290059 | Kendall A Johnson | Social Worker | 275 First Street Ext, Springfield, GA 31329-0000 | 2012-10-18 |
| 1770873101 | Kendall R Johnson | Pediatrics | 282 Washington St, Medical Education, 4h, Hartford, CT 06106-3322 | 2011-04-19 |
| 1093028318 | Kendall Dewayne Johnson | Occupational Therapy Assistant | 744 The Rialto, Venice, FL 34285-3524 | 2010-07-15 |
| Street Address |
9155 SW BARNES RD STE 333 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97225-6630 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043201981 | Mark S Fettman | Psychiatry & Neurology | 9155 Sw Barnes Rd Ste 333, Portland, OR 97225-6630 | 2005-10-31 |
| 1053968578 | Jennifer M Brinkman | Social Worker | 9155 Sw Barnes Rd Ste 333, Portland, OR 97225-6630 | 2019-08-20 |
| 1518476282 | Katrin E Beene | Clinical Neuropsychologist | 9155 Sw Barnes Rd Ste 333, Portland, OR 97225-6630 | 2017-09-26 |
| 1649684614 | Melanie Lynne Johnson | Counselor | 9155 Sw Barnes Rd Ste 333, Portland, OR 97225-6630 | 2014-06-17 |
| 1124380944 | Erika Siegel | Social Worker | 9155 Sw Barnes Rd Ste 333, Portland, OR 97225-6630 | 2012-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508425034 | Gabrielle Gonzales | Behavior Technician | 1675 Sw Marlow Ave, Suite 200, Portland, OR 97225 | 2019-06-08 |
| 1558844555 | Tate Roseberry | Behavior Technician | 1675 Sw Marlow Avenue, Suite 200, Portland, OR 97225 | 2018-09-14 |
| 1982186300 | Dean Alan Hopkins | Registered Nurse | 11782 Sw Barnes Rd, Suite 300, Portland, OR 97225 | 2018-09-01 |
| 1316449168 | Surgery Center At St. Vincent, LLC | Clinic/Center | 9135 Sw Barnes Rd Ste 161, Portland, OR 97225 | 2018-03-07 |
| 1730606716 | Meghan Louise Lacy | Pediatrics | 11790 Sw Barnes Rd, Blg. A, Suite 140, Portland, OR 97225 | 2017-08-29 |
| 1841733433 | Tia Pugh | Occupational Therapist | 9155 S.w. Barnes Road, East Pavilion, Portland, OR 97225 | 2016-11-30 |
| 1295185585 | Stephanie Lynn Hart | Nurse Practitioner | 9155 Sw Barnes Rd Ste 240, Portland, OR 97225 | 2016-06-16 |
| 1962866244 | Bejian Shamloo | Chiropractor | 10200 Sw Eastridge St., Suite 235, Portland, OR 97225 | 2016-04-12 |
| 1992162630 | Robert Joseph Yoder | Psychologist | 9045 Barnes Rd, Portland, OR 97225 | 2016-01-26 |
| 1316303951 | Katie Herold | Chiropractor | 9315 Sw Morrison St, Portland, OR 97225 | 2016-01-12 |
| Find all providers in zip 97225 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063012649 | Kathleen Russell | Social Worker | 7700 Sw Garden Home Rd Apt 23, Portland, OR 97223-7496 | 2020-10-31 |
| 1275131534 | Alice Hacker | Social Worker | 14702 Se Rhone St, Portland, OR 97236-2557 | 2020-10-09 |
| 1598372070 | Kristin Elizabeth Hajny | Social Worker | 9343 Sw Camille Ter, Portland, OR 97223-7042 | 2020-09-28 |
| 1821605759 | Melanie Smith | Social Worker | 4210 N Juneau St, Portland, OR 97203-2063 | 2020-09-24 |
| 1871100867 | Purely Spirit Holistic Health, LLC | Social Worker | 226 Stevens Ave Apt 9, Portland, ME 04102-2263 | 2020-09-24 |
| 1023624780 | Flourish Counseling and Consulting LLC | Social Worker | 8401 Ne Halsey St Ste 107, Portland, OR 97220-5670 | 2020-09-18 |
| 1245845130 | Crescent Psychotherapy | Social Worker | 168 Neal St, Portland, ME 04102-3343 | 2020-09-09 |
| 1861007676 | Yvonne Recchia | Social Worker | 5257 Ne Mlk, Portland, OR 97211-3282 | 2020-09-09 |
| 1447864327 | Gordon Keepers | Social Worker | 3181 Sw Sam Jackson Park Rd # Uhs8-l, Portland, OR 97239-3098 | 2020-09-08 |
| 1609484187 | Julie Pratt | Social Worker | 14 Culver Ln, Portland, CT 06480-1323 | 2020-07-21 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.