Jeremy Russell Johnson, LPCA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

R10828 Issued in OR

Practice address

5441 S Macadam Ave Ste N
Portland, OR 97239-6106

Phone

(909) 360-9341

NPI assigned

Feb 8, 2018

Sex

Male

Sole proprietor

No

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

State licenses

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

{
    "created_epoch": "1518048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1023517760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5441 S MACADAM AVE STE N",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972396106",
            "telephone_number": "909-360-9341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5441 S MACADAM AVE STE N",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972396106",
            "telephone_number": "909-360-9341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JEREMY",
        "middle_name": "RUSSELL",
        "credential": "LPCA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-08",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "R10828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeff Johnson
• Jeffrey P Johnson, M.D.
• Jenna Alane Johnson, LPC, CADC-I
• Jennifer Christine Johnson, PHD
• Jennifer Leigh Johnson, N.D., L.AC.
• Jesse Johnson, M.A.
• Jessica Grace Johnson, LCSW
• Jessica Leigh Johnson
• Jessica Rene Johnson, CADC 1
• Jil M Johnson, D.O.

• Mental Health Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2025; 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.