Douglas Johnson, LAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

181 Issued in KS

Practice address

6221 Richards Dr
Shawnee, KS 66216-1724

Phone

(913) 248-1943

Fax

(913) 248-1994

NPI assigned

Jun 16, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Mirror, Inc.

  • Substance Abuse Rehabilitation Facility
  • Newton, KS
  • NPI 1053431676
  NPD (past)

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

{
    "created_epoch": "1402876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402876800000",
    "number": "1124432364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 E 5TH ST",
            "address_2": "PO BOX 711",
            "city": "NEWTON",
            "state": "KS",
            "postal_code": "671142206",
            "telephone_number": "316-283-6743",
            "fax_number": "316-283-6830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6221 RICHARDS DR",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662161724",
            "telephone_number": "913-248-1943",
            "fax_number": "913-248-1994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DOUGLAS",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-16",
        "last_updated": "2014-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KS",
            "license": "181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100106710 I",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessop Dental LLC
• Jet Performance Chiropractic, PA
• Chul Hee Justin Johng, FNP-BC
• Johnson County Mental Health
• Johnson County Mental Health Center
• Lakisha Johnson
• Lindsay Ann Johnson, PHARMD
• Olivia Johnson
• Trinity Johnson
• Isaac Daniel Johnston, MD

• All providers in Shawnee, KS
• Addiction (Substance Use Disorder) Counselor in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.

Verify at the official NPI Registry.