Active NPI
Thomas Johnson Sr., LPC
- Counselor
- East Orange, NJ
National Provider Identifier
1043876618
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 2000623
- Practice address
- 220 S Harrison St
East Orange, NJ 07018-1401 - Phone
- (973) 677-7053
- NPI assigned
- May 19, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 2000623 | NJ | Primary |
Addresses
Primary practice location
220 S Harrison St
East Orange, NJ 07018-1401
Mailing address
220 S Harrison St
East Orange, NJ 07018-1401
Phone (973) 677-7053
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0314111 | Medicaid | NJ | |
| 0314129 | Medicaid | NJ |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2000623 | NJ | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558310400000",
"number": "1043876618",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "220 S HARRISON ST",
"city": "EAST ORANGE",
"state": "NJ",
"postal_code": "070181401",
"telephone_number": "973-677-7053"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 S HARRISON ST",
"city": "EAST ORANGE",
"state": "NJ",
"postal_code": "070181401",
"telephone_number": "973-677-7053"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "THOMAS",
"name_suffix": "Sr.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-05-19",
"last_updated": "2019-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NJ",
"license": "2000623",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0314111",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0314129",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in East Orange, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.