Kimberly Johnson, BS, MHPP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

612 E Arkansas St
Star City, AR 71667-4842

Phone

(870) 628-4181

Fax

(870) 628-5369

NPI assigned

Jun 8, 2016

Sex

Female

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

Credentials

Bachelor of Science

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.

• Southeast Arkansas Behavioral Healthcare System

  • Community/Behavioral Health Agency
  • Star City, AR
  • NPI 1235384009
  NPD (past)
• Southeast Arkansas Behavioral Healthcare System Inc

  • Community/Behavioral Health Agency
  • Pine Bluff, AR
  • NPI 1457398547
  NPD (past)

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

{
    "created_epoch": "1465344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465344000000",
    "number": "1194174458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 RIKE DR",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716033937",
            "telephone_number": "870-534-1834",
            "fax_number": "870-534-5798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 E ARKANSAS ST",
            "city": "STAR CITY",
            "state": "AR",
            "postal_code": "716674842",
            "telephone_number": "870-628-4181",
            "fax_number": "870-628-5369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KIMBERLY",
        "credential": "BS, MHPP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-08",
        "last_updated": "2016-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116378726",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Toni L Hobbs, BS, MHPP
• Soundra M Hogg
• Chasity Nichole Hooks, RN
• Jefferson Hospital Association, Inc
• Patricia Royals Jenkins, PD
• Amanda H Kelley
• Kenneth a Heiles, D.O. PLLC
• Leech Drug Co Inc
• Robert William Leech Jr., PD
• Alicia Levengood, PTA

• Mental Health Counselor in Star City, AR
• Providers in Star City, AR by specialty
• Mental Health Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2016; 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.