Active NPI
Theresa Johnson, MSW
- Professional Counselor
- Youngstown, OH
National Provider Identifier
1235334053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- S0031280
- Practice address
- 142 Javit CT
Youngstown, OH 44515-2409 - Phone
- (330) 793-2487
- Fax
- (330) 793-4559
- NPI assigned
- Jun 20, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | S0031280 | OH | Primary |
Addresses
Primary practice location
142 Javit CT
Youngstown, OH 44515-2409
Mailing address
142 Javit CT
Youngstown, OH 44515-2409
Phone (330) 793-2487
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 |
|---|---|---|---|
| S0031280 | OH | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1235334053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "142 JAVIT CT",
"city": "YOUNGSTOWN",
"state": "OH",
"postal_code": "445152409",
"telephone_number": "330-793-2487",
"fax_number": "330-793-4559"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "142 JAVIT CT",
"city": "YOUNGSTOWN",
"state": "OH",
"postal_code": "445152409",
"telephone_number": "330-793-2487",
"fax_number": "330-793-4559"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "THERESA",
"name_prefix": "Mrs.",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OH",
"license": "S0031280",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Youngstown, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.