Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jeremiah Johnson

Individual provider Clinical Social Worker · NPI 1669027066

Jeremiah Johnson is a Clinical Social Worker in Glendale, Wisconsin. Qualified in 2015, 11 years ago. Practices as a sole proprietor. Licensed in Wisconsin.

Years since qualifying
11
Licensed in
WI
In the registry since
2019
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Practice location Address checks out

5215 N Ironwood Rd Ste 202
Glendale, WI 53217-4908
Phone: (715) 903-6444
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 9262-123 (WI)

Record details

NPI number1669027066
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedAugust 3, 2019
Last updated in NPPESApril 20, 2026
Certification dateApril 20, 2026
Mailing address5215 N Ironwood Rd Ste 202, Glendale, WI 53217-4908

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Glendale