Stephanie Octavius- Johnson

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

6603 Beach Channel Dr
Far Rockaway, NY 11692-1433

Phone

(718) 471-8671

NPI assigned

Jul 15, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• New Horizon Counseling Center Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • South Ozone Park, NY
  • NPI 1366430563

  Single Specialty

  NPD

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

{
    "created_epoch": "1721001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1124865217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12019 143RD ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114361506",
            "telephone_number": "347-666-0938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6603 BEACH CHANNEL DR",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116921433",
            "telephone_number": "718-471-8671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OCTAVIUS- JOHNSON",
        "first_name": "STEPHANIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-15",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Onyeka Chineme Obi
• Ocean Front Medical Care PC
• Ocean House Adult Home
• Ocean Park Optical Inc.
• Oceanview Nursing & Rehabilitation Center LLC
• Semi Odeh
• Justin Gregory Odle
• Titilopemi Odunlami, MD
• Angela Yaa Oduro, D.O
• Oluwakemi Ogundalu

• All providers in Far Rockaway, NY
• Case Manager/Care Coordinator in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; 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.