Active NPI
Janice Eaton Johnson, LPC
- Professional Counselor
- Milwaukee, WI
National Provider Identifier
1063715100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 4358-125
- Practice address
- 1219 N Cass St
Milwaukee, WI 53202-2770 - Phone
- (414) 291-9487
- NPI assigned
- Dec 12, 2010
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 4358-125 | WI | Primary |
Addresses
Primary practice location
1219 N Cass St
Milwaukee, WI 53202-2770
Mailing address
1219 N Cass St
Milwaukee, WI 53202-2770
Phone (414) 291-9487
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4358-125 | WI | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1292112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1292112000000",
"number": "1063715100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1219 N CASS ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532022770",
"telephone_number": "414-291-9487"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1219 N CASS ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532022770",
"telephone_number": "414-291-9487"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "JANICE",
"middle_name": "EATON",
"name_prefix": "Mrs.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-12-12",
"last_updated": "2010-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WI",
"license": "4358-125",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.