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Deactivated NPI 1164274288 Deactivated / Inactive NPI Male Practitioner

Marcus Johnson

Social Worker • Southlake, TX

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Marcus Johnson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date April 02, 2024
NPI Deactivation Date December 12, 2024
Total Practice Duration ~1 Years of Practice (2024 – 2024)

Professional Overview & Biography Verified Profile Summary

Marcus Johnson was a registered Social Worker practicing in Southlake, TX. Throughout an active medical career spanning 1 years, Marcus Johnson provided care at the practice location at 431 E STATE HIGHWAY 114 STE 140 until profile deactivation on 2024-12-12.

Practice Location & Contact Primary Location

Practice Address

431 E State Highway 114 Ste 140

Southlake, TX 760924412

Telephone 8775813974

Specialty Benchmarks & Practice Insights

Comparative analytics for Social Worker in Southlake, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 13.4 Yrs
Regional Practice Density
7 Specialists

Practicing in Southlake, TX (3758 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Social Worker Primary Specialty

NUCC Taxonomy Code: 104100000X

State License TX 104535

A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

9 Associated Practitioners
Destinee Greenwell , LPC, LCDC

Counselor - Mental Health

NPI 1043103088

Licensed Professional Counselor, Licensed Chemical Dependency Counselor

Jeanie Jefferson , LCSW

Social Worker - Clinical

NPI 1255215984

Licensed Clinical Social Worker

Dr. Elizabeth Walker , PsyD

Psychologist - Clinical

NPI 1417751173

Doctor of Psychology (Psy.D.)

Leatha Nowlan , LPC

Counselor - Professional

NPI 1457024598

Licensed Professional Counselor

Carmen Smith , LPC

Counselor - Professional

NPI 1609426576

Licensed Professional Counselor

Robert Mullen , LPC-S

Counselor - Mental Health

NPI 1619542107

LPCS

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
⚠️
NPI Profile Deactivated December 12, 2024

Record deactivated on December 12, 2024

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Updated Practice Location October 01, 2024

Registered at 271 W SOUTHLAKE BLVD, SOUTHLAKE, TX 760927049 (Tel: 9723918885)

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Updated Business Mailing Address May 29, 2024

Registered at 431 E STATE HIGHWAY 114 FL 1, SOUTHLAKE, TX 760924412

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Medical Taxonomy / Specialty Registered (Primary Specialty) May 29, 2024

Social Worker (License #104535 in TX)

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Provider Name / Credentials Updated April 15, 2024

Recorded as MARCUS JOHNSON, LCSW

NPI Profile Active April 02, 2024

NPI status registered as active in NPPES database

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Updated Practice Location April 02, 2024

Registered at 431 E STATE HIGHWAY 114 STE 140, SOUTHLAKE, TX 760924412 (Tel: 8775813974)

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Updated Business Mailing Address April 02, 2024

Registered at 4801 BRADY CT, ARLINGTON, TX 760181446 (Tel: 8179135516)

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Provider Name / Credentials Updated April 02, 2024

Recorded as MARCUS JOHNSON

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Medical Taxonomy / Specialty Registered (Primary Specialty) April 02, 2024

Social Worker (License #104535 in TX)

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Initial NPI Registration & Enumeration April 02, 2024

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1164274288
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 02, 2024
Last Update: April 02, 2024
Deactivation Date: December 12, 2024

Mailing Address

4801 Brady Ct

Arlington, TX 760181446

Phone: 8179135516

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.