KRISTINA LEE JOHNSON (LCSW) – Clinical Social Worker, NPI 1396479788

KRISTINA LEE JOHNSON (LCSW) is a healthcare provider. based in Benton, Arkansas. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. 11766-M (AR). The NPI Number for KRISTINA LEE JOHNSON (LCSW) is 1396479788

Main info

Female
Sole Proprietor
5 Years Of Experience
Accepts Medicare Assignment
Name
KRISTINA LEE JOHNSON (LCSW)
NPI
1396479788
Phone
(501) 315-4224
Address
110 PEARSON
Enumeration Date
12 July 2022
Last Update Date
6 August 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5013154224
Graduation Year
2021 (5 years ago)
PAC ID
2365943198
Group Practice PAC ID
6204885304
Professional Enrollment ID
I20250902002772
Address ID
AR720154436BE110XXPEAR200
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness85
Years active:3State licenses:2Digital endpointsOther names

681 CLINICAL SOCIAL WORKER in AR

Provider Addresses for KRISTINA LEE JOHNSON (LCSW)

  • 110 PEARSON

    BENTON, AR 720154436

    Phone: (501) 315-4224

    Fax: (501) 778-0450

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-09-02

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250902002772IClinical Social WorkerARTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 72015)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6204885304View full group profile
NameSpecialtyState
Clinical Social WorkerAR
-MO
Clinical Social WorkerAR
Nurse PractitionerAR
Mental Health CounselorAR
Mental Health CounselorAR
Mental Health CounselorAR
Clinical Social WorkerAR
P S Y C H I A T R YAR
Clinical Social WorkerAR

Reviews

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Frequently asked questions

What is KRISTINA LEE JOHNSON (LCSW)'s NPI number?
KRISTINA LEE JOHNSON (LCSW)'s NPI is 1396479788 — the number used across U.S. healthcare to identify this provider.
Active or inactive — what applies to KRISTINA LEE JOHNSON (LCSW)?
You should see KRISTINA LEE JOHNSON (LCSW) as active in CMS-hosted NPPES data.
What area of care is associated with KRISTINA LEE JOHNSON (LCSW)?
KRISTINA LEE JOHNSON (LCSW)'s record emphasizes Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Where in Arkansas is KRISTINA LEE JOHNSON (LCSW) registered?
Use Benton, Arkansas as the headline location for KRISTINA LEE JOHNSON (LCSW) here.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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