Look up the most recent NPI and PECOS records

Justin Matthew Johnson

Social Worker

Behavioral Health & Social Service Providers

22001 Fairmount Blvd, Cleveland, OH 44118-4819

PECOS Enrollment

Based on the most recent information from CMS, provider Justin Matthew Johnson does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1508539495
Provider Type
Individual
Full Name
Johnson, Justin Matthew
Credential
LISW

Gender
Male
Sole Proprietor
No
Enumeration Date
7/27/2021
Last Updated
1/21/2025

Contact Information

Practice Location

22001 Fairmount Blvd, Cleveland, OH 44118-4819

(814) 335-5204

Unlisted Fax

Mailing Location

22001 Fairmount Blvd, Shaker Heights, OH 44118-4819

(814) 335-5204

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License I.2405788 Ohio
Code 101Y00000X	Description Counselor Behavioral Health & Social Service Providers	License Unlisted Issuer
Code 104100000X	Description Social Worker Behavioral Health & Social Service Providers	License S.2207310 Ohio

Justin Matthew Johnson

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Neuman, Judy

Criss, Elfrida

Lawrence, Mary K

Crosby, Rochena

Sanford-Russo, Janice

O'Malley Scarpitti, Danielle

Wagner, Laura

Sommer, Rosalynne Chava

Glueckselig, Nina Rachel

Ross, Kathleen V