MISS GRACELYN N JOHNSON (LCSW) – Clinical Social Worker, NPI 1295610103

MISS GRACELYN N JOHNSON (LCSW) is a healthcare provider. based in Tremont, Illinois. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. 149.029744 (IL). The NPI Number for MISS GRACELYN N JOHNSON (LCSW) is 1295610103

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
MISS GRACELYN N JOHNSON (LCSW)
NPI
1295610103
Phone
(336) 909-5946
Address
123 S SAMPSON ST
Enumeration Date
8 August 2025
Last Update Date
8 August 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3099292030
Graduation Year
2023 (3 years ago)
PAC ID
4385135763
Group Practice PAC ID
4183164973
Professional Enrollment ID
I20251113001659
Address ID
IL615688035TR123XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

3,510 CLINICAL SOCIAL WORKER in IL

Provider Addresses for MISS GRACELYN N JOHNSON (LCSW)

  • 123 S SAMPSON ST

    TREMONT, IL 615688035

    Phone: (336) 909-5946

    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: 2025-11-13

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
I20251113001659IClinical Social WorkerILTBD

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 61568)

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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: 4183164973View full group profile
NameSpecialtyState
Nurse PractitionerIL

Reviews

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Frequently asked questions

Can I cross-check MISS GRACELYN N JOHNSON (LCSW) using NPI 1295610103?
NPI 1295610103 belongs to MISS GRACELYN N JOHNSON (LCSW); compare other details if you need extra assurance.
Would MISS GRACELYN N JOHNSON (LCSW) appear as active to a payer?
You can treat MISS GRACELYN N JOHNSON (LCSW) as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with MISS GRACELYN N JOHNSON (LCSW)?
MISS GRACELYN N JOHNSON (LCSW)'s record emphasizes Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Is MISS GRACELYN N JOHNSON (LCSW) located near Tremont?
MISS GRACELYN N JOHNSON (LCSW) currently maps to Tremont, Illinois in this extract.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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