Andra Johnson, LISW, LCSW, LCAC
Andra Johnson, LISW, LCSW, LCAC is a provider specialising in Clinical Social Worker in Fort Wayne, IN, registered under NPI 1093787426. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty. NPPES records them as a sole proprietor, meaning the practice is not incorporated as a separate legal entity.
Getting there
The practice address on file is 4656 W JEFFERSON BLVD SUITE 285, Fort Wayne, IN 46804. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| 34005636A (LCSW) | IN | Clinical Social Worker primary |
| 991842 (LICDC) | OH | Addiction (Substance Use Disorder)… |
| I - 0009358 (LISW) | OH | Clinical Social Worker |
| 2979-123 (LCSW) | WI | Clinical Social Worker |
| 87000438A (LCAC) | IN | Addiction (Substance Use Disorder)… |
Licences are recorded in 3 states: IN, OH, WI. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.
This NPI does not appear in the PECOS Medicare enrolment file. Providers who do not bill Medicare — or who bill only through a group's enrolment — will not appear here. It is not a sign of any problem with the registration.
Licensed in 3 states
This provider holds licences in 3 states: Indiana, Ohio and Wisconsin. The practice address on file is in Fort Wayne, IN, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.
- Licence
- 34005636A (LCSW)
- Specialty
- Clinical Social Worker
- Licence
- 991842 (LICDC)
- Specialty
- Addiction (Substance Use Disorder)…
Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.
What Clinical covers
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. NUCC Health Care Provider Taxonomy, code 1041C0700X
All registered taxonomy codes
This provider registers 5 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 1041C0700X | Clinical Social Worker Clinical | 34005636A (LCSW) | IN | primary |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor Addiction (Substance Use Disorder) | 991842 (LICDC) | OH | |
| 1041C0700X | Clinical Social Worker Clinical | I - 0009358 (LISW) | OH | |
| 1041C0700X | Clinical Social Worker Clinical | 2979-123 (LCSW) | WI | |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor Addiction (Substance Use Disorder) | 87000438A (LCAC) | IN |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1093787426 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Feb 1, 2006 |
| Last updated | Oct 17, 2011 |
| Status | Active |
| Sole proprietor | Yes |
| Credential | LISW, LCSW, LCAC |
| Practice address |
4656 W JEFFERSON BLVD SUITE 285 Fort Wayne, IN 46804 (260) 422-9372 Fax (260) 672-0859 |
| Mailing address |
11014 CONSTANTIA CV Roanoke, IN 46783 |
| Other identifiers |
39628200 -31/078
· Medicaid (WI) |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 0 | 9 | 3 | 7 | 8 | 7 | 4 | 2 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 0 | 9 | 3 | 5 | 8 | 5 | 4 | 4 |
Sum = 64 · next multiple of 10 = 70 · check digit = 6 · actual last digit = 6
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.