Individual provider Active NPI

Anna Lynn Johnson, SAC

  • Addiction (Substance Use Disorder) Counselor
  • Lac Du Flambeau, WI
National Provider Identifier
1245992429
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
19499-130 Issued in WI
Practice address
3378 N. Schilleman Road
Lac Du Flambeau, WI 54538-0189
Phone
(715) 588-4425
NPI assigned
Oct 6, 2021
Last updated
Nov 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 19499-130 WI Primary

Addresses

Primary practice location

3378 N. Schilleman Road
Lac Du Flambeau, WI 54538-0189

Mailing address

3397 Haymeadow Rd
Rhinelander, WI 54501-8539
Phone (715) 892-5644

Other practice location 1

22 N Pelham St
Rhinelander, WI 54501-3148
Phone (715) 365-6696

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
19499-130WIMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Transitions Center LLC PastSince Feb 1, 2006 Accepting new patients
Harmony Counseling Services LLC PastSince Jan 1, 2018 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1633478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1245992429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3397 HAYMEADOW RD",
            "city": "RHINELANDER",
            "state": "WI",
            "postal_code": "545018539",
            "telephone_number": "715-892-5644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3378 N. SCHILLEMAN ROAD",
            "city": "LAC DU FLAMBEAU",
            "state": "WI",
            "postal_code": "545380189",
            "telephone_number": "715-588-4425"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22 N Pelham St",
            "address_purpose": "LOCATION",
            "city": "Rhinelander",
            "state": "WI",
            "postal_code": "545013148",
            "country_code": "US",
            "telephone_number": "715-365-6696",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ANNA",
        "middle_name": "LYNN",
        "credential": "SAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-06",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "19499-130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lac Du Flambeau, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 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.