Active NPI
Jennifer Marie Johnson, M.A., LPC
- Professional Counselor
- Jefferson City, MO
National Provider Identifier
1083943666
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2012003538
- Practice address
- 1905 Stadium Blvd
Jefferson City, MO 65109-1961 - Phone
- (573) 634-3000
- NPI assigned
- Dec 10, 2009
- Sex
- Female
- Sole proprietor
- No
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 | 2012003538 | MO | Primary |
Addresses
Primary practice location
1905 Stadium Blvd
Jefferson City, MO 65109-1961
Mailing address
PO Box 104146
Jefferson City, MO 65110-4146
Phone (573) 634-3000
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2012003538 | MO | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1260403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401321600000",
"number": "1083943666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 104146",
"city": "JEFFERSON CITY",
"state": "MO",
"postal_code": "651104146",
"telephone_number": "573-634-3000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1905 STADIUM BLVD",
"city": "JEFFERSON CITY",
"state": "MO",
"postal_code": "651091961",
"telephone_number": "573-634-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "JENNIFER",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "M.A., LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-12-10",
"last_updated": "2014-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "2012003538",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jefferson City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.