Individual provider Active NPI

Eric Johnsen, NCC (LPC)

  • Counselor
  • Newark, DE
National Provider Identifier
1023602091
Registry record updated Feb 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
PC013870 Issued in PA
Practice address
256 Chapman Rd Ste 203
Newark, DE 19702-5415
Phone
(302) 307-6558
NPI assigned
Feb 21, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X PC013870 PA Primary

Addresses

Primary practice location

256 Chapman Rd Ste 203
Newark, DE 19702-5415

Mailing address

1130 Bardell Drive
Wilmington, DE 19808
Phone (610) 324-3571

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240711001145 DE Practitioner - Mental Health Counselor 1153771878 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Diamond State Counseling LLCGroup PAC ID 1850700899, 6 clinicians

Practice addresses (Care Compare)

4550 Linden Hill Rd
Suite 152
Wilmington, DE 19808-2909
Phone (302) 683-1055

4550 New Linden Hill Rd
Suite 152
Wilmington, DE 19808-2909

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PC013870PAMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Diamond State Counseling, LLC CurrentSince Apr 25, 2024 Accepting new patients
Viamontie Counseling and Consulting Service LLC CurrentSince Mar 4, 2021 Accepting new patients
Modern Clinical Counseling Counselor CurrentSince Jun 30, 2024 Accepting new patients

Locations

256 Chapman Rd
Ste 203
Newark, DE 19702
Phone (302) 307-6558

4550 Linden Hill Rd
Ste 152
Wilmington, DE 19808
Phone (302) 683-1055

Organizations & group practices 3

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": "1613865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1023602091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 BARDELL DRIVE",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "19808",
            "telephone_number": "610-324-3571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 CHAPMAN RD STE 203",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197025415",
            "telephone_number": "302-307-6558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSEN",
        "first_name": "ERIC",
        "credential": "NCC (LPC)",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-21",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "PA",
            "license": "PC013870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.