Johanna Shields, LCSW
Social Worker, Clinical in Bloomfield, CT. Individual provider (NPI-1).
NPI number1104571306
StatusActive
Last updated in NPPESMar 19, 2024
Details
- NPI
- 1104571306
- Entity type
- Individual (NPI-1)
- Name
- Johanna Shields
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 16, 2022
- Certification date
- Mar 16, 2024
- Last updated
- Mar 19, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 9873 | CT | Yes |
Practice location
28 Hoskins RdBloomfield, CT 06002-1135
Phone 860-303-7102
Mailing address
28 Hoskins RdBloomfield, CT 06002-1135
Phone 860-303-7102
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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