Individual provider Active NPI

Ryan Mitchell Johnson, LPC

  • Counselor
  • Tulsa, OK
National Provider Identifier
1043750110
Registry record updated May 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
12093 Issued in OK
Practice address
2325 S Harvard Ave
Tulsa, OK 74114-3300
Phone
(918) 712-4301
NPI assigned
Mar 8, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 12093 OK Primary
Professional Counselor 101YP2500X 2013022750 MO

Addresses

Primary practice location

2325 S Harvard Ave
Tulsa, OK 74114-3300

Mailing address

2325 S Harvard Ave
Tulsa, OK 74114-3300
Phone (918) 712-4301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20240905003353 OK Practitioner - Mental Health Counselor 2466992433 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2325 S Harvard Ave
Tulsa, OK 74114-3300
Phone (918) 712-4301

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2013022750MOMDProfessional Counselor
12093OKMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Family & Children's Services, Inc CurrentSince Jun 22, 2024 Accepting new patients
Family & Children's Services, Inc CurrentSince Jun 22, 2024 Accepting new patients

Locations

2325 S Harvard Ave
Tulsa, OK 74114
Phone (918) 921-3200

650 S Peoria Ave
Tulsa, OK 74120
Phone (918) 560-1200

Organizations & group practices 2

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": "1488931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716508800000",
    "number": "1043750110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2325 S HARVARD AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741143300",
            "telephone_number": "918-712-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 S HARVARD AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741143300",
            "telephone_number": "918-712-4301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RYAN",
        "middle_name": "MITCHELL",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-08",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OK",
            "license": "12093",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2013022750",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.