Active NPI
Lydia Johnson, M.A.,L.P.C., A.T.R.
- Professional Counselor
- Waukesha, WI
National Provider Identifier
1194076604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 4887-125
- Practice address
- 20700 Watertown Rd
Suit 102
Waukesha, WI 53186-1800 - Phone
- (262) 782-1474
- Fax
- (262) 782-1441
- NPI assigned
- Sep 24, 2012
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 4887-125 | WI | Primary |
Addresses
Primary practice location
20700 Watertown Rd
Suit 102
Waukesha, WI 53186-1800
Mailing address
2979 N 53Rd St
Milwaukee, WI 53210-1616
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4887-125 | WI | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Life Resources, Inc. | Professional | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348444800000",
"number": "1194076604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2979 N 53RD ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532101616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20700 WATERTOWN RD",
"address_2": "SUIT 102",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531861800",
"telephone_number": "262-782-1474",
"fax_number": "262-782-1441"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "LYDIA",
"credential": "M.A.,L.P.C., A.T.R.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-24",
"last_updated": "2012-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WI",
"license": "4887-125",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waukesha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.