Individual ProviderIan M JohnsonSocial WorkerBehavioral Health & Social Service ProvidersPractice Address289 S 1st St, Apt 2d, Brooklyn, NY 11211-4578(585) 506-7435PECOS EnrollmentBased on the most recent information from CMS, provider Ian M Johnson does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 9:43 AM.Profile DetailsProvider ID1144662503Provider TypeIndividualFull NameJohnson, Ian MTitleMr.CredentialLCSWGenderMaleSole ProprietorNoEnumeration Date7/25/2013Last Updated9/22/2016Contact InformationPractice LocationPractice Address289 S 1st St, Apt 2d, Brooklyn, NY 11211-4578Phone(585) 506-7435FaxUnlisted FaxMailing LocationMailing Address289 S 1st St, Apt 2d, Brooklyn, NY 11211-4578Phone(585) 506-7435FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense088172New YorkCode104100000XDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense088172-1New York