Individual ProviderTimothy JohnsonSocial WorkerBehavioral Health & Social Service ProvidersPractice Address4633 Aicholtz Rd, Cincinnati, OH 45244-1447(513) 752-1555PECOS EnrollmentBased on the most recent information from CMS, provider Timothy 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 2 days ago.Profile DetailsProvider ID1962232702Provider TypeIndividualFull NameJohnson, TimothyCredentialLSWGenderMaleSole ProprietorNoEnumeration Date8/6/2024Last Updated11/11/2025Contact InformationPractice LocationPractice Address4633 Aicholtz Rd, Cincinnati, OH 45244-1447Phone(513) 752-1555FaxUnlisted FaxMailing LocationMailing Address4629 Aicholtz Rd Ste 2, Cincinnati, OH 45244-1560PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode104100000XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseS.2512543OhioCode171M00000XDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted Issuer