MR. KENNETH L JOHNSON III (NPI# 1174976310) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174976310 |
| Entity Type | Individual |
| Full Name | MR. KENNETH L JOHNSON III |
| Credential | LSW |
| Practice Address |
2305 Fairmount Ave Philadelphia PA 19130-2515 |
| Mailing Address |
7804 Thouron Ave Philadelphia PA 19150-2514 |
| Practice Telephone | 2673072696 |
| Mailing Telephone | 2673072696 |
| Enumeration Date | 2016-07-22 |
| Last Update Date | 2016-07-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
SW131341 | PA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487144952 | Kenneth Cornell Johnson Jr. | Counselor | 91 Park Ave W, Mansfield, OH 44902-1630 | 2018-05-10 |
| 1043756414 | Kenneth Byron Johnson | Physical Therapist | 36 Lavelle Court, Unalaska, AK 99685 | 2017-01-10 |
| 1932565280 | Kenneth Johnson | Case Manager/Care Coordinator | 1138 N Dupre St, New Orleans, LA 70119-3204 | 2015-12-31 |
| 1003223298 | Kenneth Johnson | Specialist/Technologist | 6201 San Amaro Dr, Coral Gables, FL 33146-2407 | 2014-07-19 |
| 1831511807 | Kenneth Larry Johnson I | Local Education Agency (LEA) | 216 Ne 19th Ave, Pompano Beach, FL 33060-6743 | 2014-01-10 |
| 1700222544 | Kenneth Paul Johnson | Pharmacist | 506 Augsburg Ave, Bismarck, ND 58504-7005 | 2013-05-20 |
| 1528302635 | Kenneth James Johnson | Pharmacist | 8145 Rhode Island Cir, 1, Bloomington, MN 55438-1152 | 2012-11-15 |
| 1760750194 | Kenneth Casper Johnson | Obstetrics & Gynecology | 3915 Skyline Rd, Carlsbad, CA 92008-2746 | 2011-12-13 |
| 1225305931 | Kenneth Lorenzo Johnson | Psychologist | 7605 W 7 Mile Rd, Detroit, MI 48221-2163 | 2011-11-23 |
| 1528371408 | Kenneth Johnson | Physical Therapist | 10753 Falls Rd Ste 235, Lutherville, MD 21093-4597 | 2010-07-20 |
| Street Address |
2305 FAIRMOUNT AVE |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19130-2515 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205050820 | Suzanne Langner | Nurse Practitioner | 2305 Fairmount Ave, Philadelphia, PA 19130-2515 | 2007-04-13 |
| 1639532237 | Jacqueline Jaffe O'duor, LLC | Social Worker | 2305 Fairmount Ave, Philadelphia, PA 19130-2515 | 2016-03-31 |
| 1700259454 | Amanda Geraci | Social Worker | 2305 Fairmount Ave, Philadelphia, PA 19130-2515 | 2015-11-03 |
| 1518338144 | Shaylyn M Forte | Counselor | 2305 Fairmount Ave, Philadelphia, PA 19130-2515 | 2015-10-08 |
| 1790033520 | Jacqueline Jaffe O'duor | Social Worker | 2305 Fairmount Ave, Philadelphia, PA 19130-2515 | 2012-08-28 |
| 1851647192 | Jill Suzanne Maier | Counselor | 2305 Fairmount Ave, Philadelphia, PA 19130-2515 | 2012-07-24 |
| 1902054489 | Katie Jane Santana | Social Worker | 2305 Fairmount Ave, Philadelphia, PA 19130-2515 | 2008-09-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912518226 | Karen Dybner-madero | Psychologist | 2201 Pennsylvania Avenue, The Parkway House, Suite 101, Philadelphia, PA 19130 | 2020-08-11 |
| 1689213456 | Nora Marie Corbett | Physical Therapist | 1714 Fairmount Avenue, Philadelphia, PA 19130 | 2019-12-27 |
| 1104470665 | Thibault Counseling LLC | Clinic/Center | 2049 North Street, Philadelphia, PA 19130 | 2019-08-01 |
| 1619444577 | Rebecca Boova | Dietitian, Registered | 1644 Francis St, #3, Philadelphia, PA 19130 | 2018-10-30 |
| 1184191108 | Sharon Marie Thompson | Nurse Practitioner | School District of Philadelphia/school Health Services, 440 North Broad Street, Philadelphia, PA 19130 | 2018-10-29 |
| 1861918542 | Theresa Mary Thompson | Dental Hygienist | Delaware Valley Community Health, 1412 Fairmount Avenue, Philadelphia, PA 19130 | 2017-08-15 |
| 1023539806 | Marina France | Social Worker | 2401 Pennsylvania Ave Ste 1a2, Philadelphia, PA 19130 | 2017-06-30 |
| 1619425063 | Sarah Nash | Dietitian, Registered | 420 North 20th Street, Philadelphia, PA 19130 | 2016-09-14 |
| 1154737757 | Julia Ferrence | Social Worker | 2305 Fairmount Avenue, Philadelphia, PA 19130 | 2014-07-03 |
| 1811319924 | Larry H Goldberg | Internal Medicine | 2441 Olive Street, Philadelphia, PA 19130 | 2014-01-08 |
| Find all providers in zip 19130 | ||||
| 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 |
|---|---|---|---|---|
| 1215538657 | Noel Mitchell | Social Worker | 410 Memphis St, Philadelphia, PA 19125-2642 | 2020-11-03 |
| 1326649963 | Sarah Michelle Waxman | Social Worker | 2550 Grays Ferry Ave, Philadelphia, PA 19146-2331 | 2020-11-02 |
| 1467051540 | Maya Cox | Social Worker | 4045 Green St, Philadelphia, PA 19104-1759 | 2020-10-20 |
| 1679170575 | Wendy Diane Nickerson | Social Worker | 741 S 2nd St, Philadelphia, PA 19147-3425 | 2020-10-04 |
| 1497362404 | Lora M Rhodes | Social Worker | 925 Chestnut St Ste 321a, Philadelphia, PA 19107-4216 | 2020-09-24 |
| 1841806395 | Molly Vocino | Social Worker | 925 Chestnut St Ste 422u, Philadelphia, PA 19107-4216 | 2020-09-21 |
| 1306452065 | Rebecca Cammy | Social Worker | 925 Chestnut St # 422w, Philadelphia, PA 19107-4216 | 2020-09-18 |
| 1598378663 | Suzanne Banning Anderson | Social Worker | Sayre High School, 5800 Walnut St, Philadelphia, PA 19139 | 2020-08-28 |
| 1265045272 | Lisa Gabrielle Schilansky | Social Worker | 4813 Springfield Ave Apt 1, Philadelphia, PA 19143-3409 | 2020-08-28 |
| 1962015537 | Joanna Elizabeth Vanore | Social Worker | 4725 Sheldon St, Philadelphia, PA 19127-1008 | 2020-08-24 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19130 |
Please comment or provide details below to improve the information on MR. KENNETH L JOHNSON III.
| 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.