Nicole N Johnson, BS

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

14736 94TH Ave Apt 10N
Jamaica, NY 11435-4545

Phone

(718) 374-4579

NPI assigned

Jun 30, 2021

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

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

{
    "created_epoch": "1625011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1194395202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14736 94TH AVE APT 10N",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114354545",
            "telephone_number": "718-374-4579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14736 94TH AVE APT 10N",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114354545",
            "telephone_number": "718-374-4579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "NICOLE",
        "middle_name": "N",
        "credential": "BS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-30",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Brooklyn",
            "affiliation": "Y",
            "endpointDescription": "Brooklyn",
            "affiliationName": "Marathon Infants and Toddlers",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "14736 94th Ave Apt 10N",
            "city": "Jamaica",
            "state": "NY",
            "country_code": "US",
            "postal_code": "114354545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bridgette S Johnson
• Cheron Johnson
• Cynthia Johnson
• Keith Michael Johnson, C.A.S.A.C.
• Marian Diane Johnson
• Sharon Johnson
• Solake Johnson
• Sylvia Johnson
• Tamara Johnson, LPN
• Teka Johnson

• Counselor in Jamaica, NY
• Providers in Jamaica, NY by specialty
• Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.

Verify at the official NPI Registry.