JENNIFER TRIMBLE JOHNSON LICSW - NPI 1306366612

Q: What is the provider's specialty?

The provider's specialty is Counselor with taxonomy code 101YM0800X and a focus in Mental Health.

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About Jennifer Trimble Johnson Licsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JENNIFER TRIMBLE JOHNSON LICSW (NPI 1306366612) is an individual mental health provider in Madison, Alabama, licensed in Alabama (2192C-1074) and active in the NPI registry since June 2017. She is enrolled in Medicare PECOS and is a graduate of University Of Alabama School Of Medicine (2003).

NPPES Registry Identity

NPI1306366612

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameJENNIFER TRIMBLE JOHNSONCredential: LICSW

Location Address350 SUN TEMPLE DRMadison, AL 35758-5919

Mailing Address2514 Quail Ridge Ln SwHuntsville, AL 35803-3534 · (256) 653-0904

Phone(256) 325-2627

Sole ProprietorYes

Medical School CMSUniversity Of Alabama School Of MedicineGraduated 2003

Enumeration DateJune 27, 2017

✔ NPI 1306366612 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

License✔ Licensed in AL · 2192C-1074

350 SUN TEMPLE DR, Madison, AL 35758

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Alabama, Oscar Insurance Company, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jennifer Trimble Johnson Licsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3476828054

PECOS Enrollment IDI20171006002505

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LAUREN ROSS CRNP

Nurse Practitioner (Psychiatric/Mental Health)