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

Mr. Kendall M Johnson, LCSW

Individual provider Social Worker · NPI 1073659298

Mr. Kendall M Johnson, LCSW is a Clinical Social Worker in Portland, Oregon. Qualified in 2003, 23 years ago. Practices with Providence Health and Services Oregon, a 1,426-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in New York and Oregon.

Years since qualifying
23
Licensed in
NY, OR
In the registry since
2007
Specialties on file
3
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

See every abbreviation used in this directory →

Practice location Address checks out

9155 SW Barnes Rd Ste 333
Portland, OR 97225-6630
Phone: (503) 216-5102
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 9450 Sw Barnes Rd, Portland, OR 97225-6619 — (503) 216-5016

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence L5441
Social Worker Taxonomy 104100000X · Licence L5441 (OR)
Clinical Social Worker Taxonomy 1041C0700X · Licence 075642 (NY)

Record details

NPI number1073659298
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorYes
NPI enumeratedJanuary 29, 2007
Last updated in NPPESMarch 24, 2020
Certification dateMarch 24, 2020

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Group practice Providence Health And Services Oregon — 1426 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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