Kathryn Alicia Johnson, BS, CAC-AD

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

AC2456 Issued in MD

Practice address

21 Industrial Park Dr Ste 104D
Waldorf, MD 20602-2751

Phone

(301) 818-0030

NPI assigned

Mar 13, 2018

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

State licenses

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

{
    "created_epoch": "1520899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520899200000",
    "number": "1215430541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 INDUSTRIAL PARK DR STE 104D",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206022751",
            "telephone_number": "301-818-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 INDUSTRIAL PARK DR STE 104D",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206022751",
            "telephone_number": "301-818-0030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KATHRYN",
        "middle_name": "ALICIA",
        "name_prefix": "Mrs.",
        "credential": "BS, CAC-AD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-13",
        "last_updated": "2018-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MD",
            "license": "AC2456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheyenne Johnson
• Christian Aaron Johnson, D.M.D.
• Crystal Johnson, CAC-AD
• Dalton James Johnson Jr., L.C.P.C.
• Denise Smith Johnson, PA-C
• Lashay Johnson, LCPC
• Leah Johnson
• Rene Johnson, CRNP
• Ron C Johnson, LGPC, NCC
• Starr Johnson

• Addiction (Substance Use Disorder) Counselor in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Addiction (Substance Use Disorder) Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2018; 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.