Jade Johansen, NCC, M. ED.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

Goal Mentality, LLC
10375 Ford Ave Building a, Suite 3
Richmond Hill, GA 31324

Phone

(912) 500-5800

NPI assigned

Dec 6, 2022

Last updated

Dec 6, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

Practice roles

Locations

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.

• Goal Mentality LLC

  • Clinical Psychologist
  • Richmond Hill, GA
  • NPI 1376249268

  Mental Health

  NPD

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

{
    "created_epoch": "1670284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1053022566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "GOAL MENTALITY, LLC",
            "address_2": "10375 FORD AVE BUILDING A, SUITE 3",
            "city": "RICHMOND HILL",
            "state": "GA",
            "postal_code": "31324",
            "telephone_number": "912-500-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "GOAL MENTALITY, LLC",
            "address_2": "10375 FORD AVE BUILDING A, SUITE 3",
            "city": "RICHMOND HILL",
            "state": "GA",
            "postal_code": "31324",
            "telephone_number": "912-500-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHANSEN",
        "first_name": "JADE",
        "credential": "NCC, M. ED.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-06",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jade@goalmentality.com",
            "affiliation": "N",
            "endpointDescription": "Work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "Goal Mentality, LLC",
            "address_2": "10375 Ford Ave Building A, Suite 3",
            "city": "Richmond Hill",
            "state": "GA",
            "country_code": "US",
            "postal_code": "31324",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jean Goldthwait LCSW
• Danielle Jeffrie
• Mackenzie Jeffries
• Larhonda Jenkins
• Tanaya Jenkins
• Christina Michelle Johnson, PA-C
• Destiny A Johnson
• Kristina Nicole Johnson, M.D.
• Latarsha Monek Johnson, NURSE PRACTITIONER
• Tishlyn Johnson

• Mental Health Counselor in Richmond Hill, GA
• Providers in Richmond Hill, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; 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.