Lucy Johnson

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

2023167287 Issued in GA

Practice address

2700 Braselton Hwy Ste 10-278
Dacula, GA 30019-3262

Phone

(678) 887-9315

NPI assigned

Oct 8, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Kairos Life and Wellness LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Dacula, GA
  • NPI 1013835271

  Psychiatric/Mental Health

  NPD (past) Authorized official

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

{
    "created_epoch": "1728345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1144049909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 BRASELTON HWY STE 10-278",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300193262",
            "telephone_number": "678-887-9315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 BRASELTON HWY STE 10-278",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300193262",
            "telephone_number": "678-887-9315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LUCY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-08",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "2023167287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jehovahs Behavioral Care LLC
• Youn Jeoung, PHARMD
• Amreen Jivani, PHARMD
• Cordelia Johnbull, PMHNP
• Jamie Johnson
• Amanda Johnston, NP-C
• Daniel Ray Jones, D.D.S.
• Madison Jones, OTR/L
• Mary Finlayson Jones
• Shannon Marie Jones, MD

• All providers in Dacula, GA
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.