Staci Johnson, LAC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LAC-22673 Issued in AZ

Practice address

2314 S Val Vista Dr Ste 101
Gilbert, AZ 85295-5591

Phone

(480) 804-0326

Fax

(480) 804-0083

NPI assigned

Feb 16, 2024

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 names 1

• Staci Watkins Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1708041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1225893464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E SOUTHERN AVE STE 735",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852825699",
            "telephone_number": "480-804-0326",
            "fax_number": "480-804-0083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2314 S VAL VISTA DR STE 101",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852955591",
            "telephone_number": "480-804-0326",
            "fax_number": "480-804-0083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "STACI",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-16",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LAC-22673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACI",
            "last_name": "WATKINS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Paige Johnson, PT, DPT
• Phillip Ryan Johnson, R.PH.
• Rachel Johnson, PHARMD
• Sarah Elizabeth Johnson, D.M.D.
• Shawmbria Johnson
• Tamara Joy Johnson, D.O.
• Teegan Johnson
• Troy Johnson Jr.
• Veronica Johnson, M.S. CF-SLP
• Kelly D Johnston-Messenger, PMHNP-BC

• Mental Health Counselor in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Mental Health Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2024; 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.