Theresa M Johnson, RN BC APRN LADC
Individual provider Active NPI Counselor · West Hurtford, CT
NPI 1124233473 · NPPES record last updated Sep 11, 2025
Key facts
- NPI
- 1124233473
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- LADC000161 (CT)
- Practice address
- 361 Park Rd
3Rd FL
West Hurtford, CT 06119 - Phone
- (860) 523-1101
- NPI assigned
- May 11, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LADC000161 | CT | MD | Counselor |
| RNE33028 | CT | MD | Registered Nurse |
| APRN002487 | CT | MD | Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | LADC000161 | CT | Yes |
| Registered Nurse | 163W00000X | RNE33028 | CT | |
| Nurse Practitioner | 363L00000X | APRN002487 | CT |
Addresses
Primary practice location
361 Park Rd
3Rd FL
West Hurtford, CT 06119
Mailing address
9A Farmington Chase Crescent
Farmington, CT 06032-3132
Phone (860) 677-0367
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.