Benetta E Johnson, PHD, HSPP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

99034346A Issued in IN

Practice address

5610 Crawfordsville Rd
Suite 200
Indianapolis, IN 46224-3714

Phone

(317) 241-4673

Fax

(317) 241-0201

NPI assigned

Oct 21, 2008

Last updated

Nov 15, 2016By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hope Haven Psychological Resource, LLC

  • Psychologist
  • Indianapolis, IN
  • NPI 1679858831
  Medicare reassignment NPD
• Healthnet, Inc.

  • Federally Qualified Health Center (FQHC)
  • Indianapolis, IN
  • NPI 1780634964
  NPD (past)
• Julian Center Inc

  • Psychologist
  • Indianapolis, IN
  • NPI 1407900483
  NPD (past)

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479168000000",
    "number": "1194977298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5610 CRAWFORDSVILLE RD",
            "address_2": "SUITE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462243714",
            "telephone_number": "317-241-4673",
            "fax_number": "317-241-0201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5610 CRAWFORDSVILLE RD",
            "address_2": "SUITE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462243714",
            "telephone_number": "317-241-4673",
            "fax_number": "317-241-0201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BENETTA",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "PHD, HSPP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-21",
        "last_updated": "2016-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "99034346A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Annelyssa Nicole Johnson, M.D.
• Ashley Johnson
• Audrey Elizabeth Johnson, DDS
• Aysia C Johnson
• Barbara Claire Johnson
• Benjamin Johnson
• Benjamin Johnson
• Bevan Ellis Johnson, MD, MBA
• Brett Arsenio Johnson, MD
• Breya L Johnson

• Mental Health Counselor in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Mental Health Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.