Active NPI
Kory Lee Johnson, LPC
- Mental Health Counselor
- Kettering, OH
National Provider Identifier
1215449822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- C.1700702
- Practice address
- 529 E Stroop Rd
Kettering, OH 45429-3245 - Phone
- (937) 294-6004
- Fax
- (937) 294-9053
- NPI assigned
- Nov 5, 2017
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | C.1700702 | OH | Primary |
Addresses
Primary practice location
529 E Stroop Rd
Kettering, OH 45429-3245
Mailing address
529 E Stroop Rd
Kettering, OH 45429-3245
Phone (937) 294-6004
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C.1700702 | OH | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1509840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1509840000000",
"number": "1215449822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "529 E STROOP RD",
"city": "KETTERING",
"state": "OH",
"postal_code": "454293245",
"telephone_number": "937-294-6004",
"fax_number": "937-294-9053"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "529 E STROOP RD",
"city": "KETTERING",
"state": "OH",
"postal_code": "454293245",
"telephone_number": "937-294-6004",
"fax_number": "937-294-9053"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "KORY",
"middle_name": "LEE",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-11-05",
"last_updated": "2017-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OH",
"license": "C.1700702",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kettering, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.