Providers

TONYA JOHNSON, LCSW

NPI 1750710232, individual, Newport News, VA, Social Worker, Clinical

4
Evidence tier
structure or single-organization volume
  • Hours beyond a day in 16 months under one organization, which can be supervisory billing.
  • Records needed.
score 52 of 100, rank 8462, $4.0M at stake

Hours billed per day

Medicaid billing converted into hours of hands-on care per day. The lower bound counts one unit per claim line and needs no price; the other two divide dollars by a unit price, the conservative one at 1.5 times the price. The clinician on the claim may be a supervisor under state rules, so billing organizations are counted too.

monthwhat was foundhours per day, lower boundhours per day, at pricehours per day, conservativeper working daypatientsbilling organizationscodespaid
Jul 2022More hours than a day holds at a conservative unit price11.045.430.344.7351190834$115K
Aug 2022More hours than a day holds at a conservative unit price11.745.030.040.4344190834$114K
Sep 2022More hours than a day holds at a conservative unit price12.146.931.242.6349190834$115K
Oct 2022More hours than a day holds at a conservative unit price14.855.837.254.9426190834$141K
Nov 2022More hours than a day holds at a conservative unit price14.658.739.153.3437190834$143K
Dec 2022More hours than a day holds at a conservative unit price13.956.537.753.1433190834$143K
Jan 2023More hours than a day holds at a conservative unit price14.452.334.949.2440190834$142K
Feb 2023More hours than a day holds at a conservative unit price17.662.641.758.4498190834$153K
Mar 2023More hours than a day holds at a conservative unit price16.659.139.453.1494190834$160K
Apr 2023More hours than a day holds at a conservative unit price14.348.432.348.4428190791 90834$127K
May 2023More hours than a day holds at a conservative unit price13.945.830.541.1391190834$124K
Jun 2023More hours than a day holds at a conservative unit price15.942.828.538.9378190834$112K
Jul 2023More hours than a day holds at a conservative unit price13.342.428.341.7385190834$115K
Aug 2023More hours than a day holds at a conservative unit price11.839.526.335.5335190834$107K
Nov 2023More hours than a day holds at a conservative unit price11.038.025.434.6309190834$100K
Apr 2024More hours than a day holds at a conservative unit price11.836.524.333.2312190834$109K

National provider registry

From the CMS NPPES Registry, refreshed daily.

NameTONYA JOHNSON, LCSW
TypeIndividual
StatusActive
NPI issuedNovember 5, 2013, last updated November 2, 2018
Practice location610 THIMBLE SHOALS BLVD # 403, Newport News, VA 23606-2573, 757-291-3339
Specialties
Social Worker, Clinical (1041C0700X, primary, license 0904008625 VA)
Counselor, Mental Health (101YM0800X)

Procedures billed

The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.

Medicaid, largest codes
codewhat it ispaidshareper patient-monthtypicalrank among providers
90834Psychotherapy, 45 minutes$4.4M95%$306$101 (top 5% from $318)94th percentile
90837Psychotherapy, 1 hourhistory of abuse$159K3%$238$191 (top 5% from $442)68th percentile
H0046Medicaid service code$47K1%$2K$60 (top 5% from $2K)too few months to rank
90791Psychiatric diagnostic evaluation$3K0%$99$105 (top 5% from $228)too few months to rank

In this area

2 providers in Newport News city County, VA carry an indicator in the public record, with $118K at stake between them. The most common is part of a provider network, on 2 of them.

tierproviderat stakewhy
3AFFINITY CARE OF VIRGINIA LLC
Newport News, VA, ranked 1343
$118K
  • Part of provider network D1-00113, ranked 113 nationally.
3OLD DOMINION REHABILITATION AND NURSING LLC
Newport News, VA, ranked 4733
$0
  • Part of provider network D1-00004, ranked 4 nationally.

Recent enforcement in VA

All releases

Department of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.

DOJChargedJun 23, 2026
U.S. Attorney’s Office announces charges against three defendants in the Eastern District of Virginia as part of national health care fraud takedown
Three defendants were charged with fraudulently billing Medicaid for mental health services that were not provided and with submitting false claims to Medicare through a straw-owned durable medical equipment company.
DOJSentencedJun 5, 2026
Medicaid service providers sentenced for false statements resulting in overbilling
Wright and Winfield instructed CCR employees to falsely claim in progress notes that children received therapeutic day treatment services from 2:00pm to 7:00pm, including providing prefilled progress note templates, resulting in overbilling to Medicaid.
DOJCivil settlementApr 27, 2026
Tri-Area Community Health Agrees to Pay $513,000 to Resolve Medicare Billing Allegations
Tri-Area Community Health billed Medicare for Annual Wellness Visits provided by pharmacists without appropriate physician supervision that were billed under the names of physicians not involved with the visits.
DOJSentencedMar 17, 2026
Six Sentenced in Healthcare Fraud Conspiracy that Stole $10 Million from Medicaid Over Six-Year Period
Six defendants conspired to submit false claims to Virginia Medicaid on behalf of 1st Adult N Pediatric Healthcare Services for nursing and personal care services that were not provided, including falsifying records and paying parents or guardians of patients for blank, signed nursing notes.
DOJIndictedMar 11, 2026
Victim Advisory- Divine Youth Case Updates
Divine Youth Counseling submitted more than $11 million in fraudulent Medicaid claims for Crisis Stabilization and Mobile Crisis services by falsely claiming two mental health professionals provided Team Treatment services and paid more than $470,000 in kickbacks in the form of hotel rooms for Medicaid recipients.

Referral packet

The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.

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