Active NPI
Nelly Johnson
- Marriage & Family Therapist
- Santa Clarita, CA
National Provider Identifier
1174946560
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- IMF788485
- Practice address
- 21125 Centre Pointe Pkwy
Santa Clarita, CA 91350-2994 - Phone
- (554) 353-8018
- NPI assigned
- Jan 21, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | IMF788485 | CA | Primary |
Addresses
Primary practice location
21125 Centre Pointe Pkwy
Santa Clarita, CA 91350-2994
Mailing address
602 Commerce Ave Ste E
Palmdale, CA 93551-3882
Phone (661) 810-3671
Other practice location 1
43552 Yew St
Lancaster, CA 93536-6622
Phone (661) 350-2167
Other practice location 2
602 Commerce Ave Ste E
Palmdale, CA 93551
Phone (661) 810-3671
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMF788485 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mindful Lemon Marriage and Family Therapy, Inc | Marriage & Family Therapist | Current | Accepting new patients |
| Counseling Center for Growth and Development; a Professional Marriage | Marriage & Family Therapist | Past | Accepting new patients |
Locations
21125 Centre Pointe Pkwy
Santa Clarita, CA 91350
Phone (554) 353-8018
Organizations & group practices 2
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Santa Clarita, CA
- NPI 1487324463
Marriage & Family Therapist
-
- Marriage & Family Therapist
- Palmdale, CA
- NPI 1538698295
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1390262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634860800000",
"number": "1174946560",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "602 COMMERCE AVE STE E",
"city": "PALMDALE",
"state": "CA",
"postal_code": "935513882",
"telephone_number": "661-810-3671"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21125 CENTRE POINTE PKWY",
"city": "SANTA CLARITA",
"state": "CA",
"postal_code": "913502994",
"telephone_number": "554-353-8018"
}
],
"practiceLocations": [
{
"address_1": "43552 Yew St",
"address_purpose": "LOCATION",
"city": "Lancaster",
"state": "CA",
"postal_code": "935366622",
"country_code": "US",
"telephone_number": "661-350-2167",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "602 Commerce Ave Ste E",
"address_purpose": "LOCATION",
"city": "Palmdale",
"state": "CA",
"postal_code": "93551",
"country_code": "US",
"telephone_number": "661-810-3671",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "NELLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-01-21",
"last_updated": "2021-10-22",
"certification_date": "2021-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "IMF788485",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Santa Clarita, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.