Ricky Lee Johansen Jr., PH.D.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

3727 Princeton CT SE
Lacey, WA 98503-4150

Phone

(360) 357-4707

Fax

(360) 357-4707

NPI assigned

Feb 21, 2008

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1203552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203552000000",
    "number": "1003085309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3185",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985093185",
            "telephone_number": "360-357-4707",
            "fax_number": "360-357-4707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3727 PRINCETON CT SE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985034150",
            "telephone_number": "360-357-4707",
            "fax_number": "360-357-4707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHANSEN",
        "first_name": "RICKY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-21",
        "last_updated": "2008-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theodore Basil Jerdes, LMP
• McKina May Jewell
• Doris Jin
• Xiaoqing Jin, MA 61324090
• Christa Jobb, LMP
• John P. Holland, MD, PC
• Aaron Micheal Johnson
• Anthony Johnson
• Carissa Michelle Johnson
• Cris Edward Johnson, MD

• Mental Health Counselor in Lacey, WA
• Providers in Lacey, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.