Individual provider Active NPI

Arnise Lanell Johnson, PH.D.

  • Psychologist
  • Arcadia, FL
National Provider Identifier
1033816038
Registry record updated Feb 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY6572 Issued in FL
Practice address
725 N 12TH Ave BLDG B
Arcadia, FL 34266-8752
Phone
(863) 494-1242
NPI assigned
Feb 9, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY6572 FL
Psychologist 103T00000X PY6572 FL Primary

Addresses

Primary practice location

725 N 12TH Ave BLDG B
Arcadia, FL 34266-8752

Mailing address

101 Riverfront Blvd Ste 710
Bradenton, FL 34205-8812
Phone (941) 776-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20230228002493 FL Practitioner - Clinical Psychologist 9234502964 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ace Behavioral Health LLCGroup PAC ID 2668984675, 38 clinicians

Practice addresses (Care Compare)

232 N Orange Blossom TRL
Orlando, FL 32805-1612
Phone 4074285751329

5406 Hoover Blvd
Suite 18
Tampa, FL 33634-5330
Phone (866) 770-4104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY6572FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
MCR Health, Inc. CurrentSince Feb 16, 2023 Accepting new patients
Ace Behavioral Health LLC Psychologist CurrentSince May 1, 2025 Accepting new patients
MCR Health, Inc. CurrentSince Feb 16, 2023 Accepting new patients
Citrus County Rural Health Inc CurrentSince Sep 1, 2025 Accepting new patients

Locations

725 N 12th Ave
Bldg B
Arcadia, FL 34266
Phone (863) 494-1242

101 Riverfront Blvd
Ste 710
Bradenton, FL 34205

927 N Citrus Ave
Crystal River, FL 34428
Phone (352) 404-5588

12271 US Highway 301 N
Parrish, FL 34219
Phone (941) 713-2231

5406 Hoover Blvd
Ste 18
Tampa, FL 33634
Phone (813) 880-7577

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1675900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675987200000",
    "number": "1033816038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 RIVERFRONT BLVD STE 710",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342058812",
            "telephone_number": "941-776-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 N 12TH AVE BLDG B",
            "city": "ARCADIA",
            "state": "FL",
            "postal_code": "342668752",
            "telephone_number": "863-494-1242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ARNISE",
        "middle_name": "LANELL",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-09",
        "last_updated": "2023-02-10",
        "certification_date": "2023-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY6572",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY6572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcadia, FL

Sources for this page

Verify at the official NPI Registry.