Individual provider Active NPI

Caitlin Mariah Johnson, LPC, CRC

  • Mental Health Counselor
  • Dalton, GA
National Provider Identifier
1003454711
Registry record updated Dec 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC011311 Issued in GA
Practice address
1414 Dug Gap Rd
Dalton, GA 30720-5007
Phone
(706) 279-0405
NPI assigned
Dec 12, 2019
Last updated
Dec 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPC011311 GA Primary

Addresses

Primary practice location

1414 Dug Gap Rd
Dalton, GA 30720-5007

Mailing address

725 Mountain Laurel Dr
Canton, GA 30114-1272
Phone (706) 889-3174

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPC011311GAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Family and Children First LLC CurrentSince Dec 21, 2021 Accepting new patients

Locations

1414 Dug Gap Rd
Dalton, GA 30720
Phone (706) 279-0405

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1576108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576108800000",
    "number": "1003454711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 MOUNTAIN LAUREL DR",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301141272",
            "telephone_number": "706-889-3174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 DUG GAP RD",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307205007",
            "telephone_number": "706-279-0405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CAITLIN",
        "middle_name": "MARIAH",
        "credential": "LPC, CRC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-12",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC011311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; 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.