Johanna Pena, RIC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

19248 Tidewater TRL
Fredericksburg, VA 22408-9357

Phone

(954) 881-2169

NPI assigned

Aug 24, 2023

Sex

Female

Sole proprietor

Yes

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

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prince William County Community Services BoardGroup PAC ID 7113912973, 57 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Prince William County Community Services Board

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Manassas, VA
  • NPI 1053402800
  Medicare reassignment Care Compare group NPD
• Prince William County

  • Ambulance
  • Prince William, VA
  • NPI 1235437385
  NPD

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

{
    "created_epoch": "1692835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1265217699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19248 TIDEWATER TRL",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224089357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19248 TIDEWATER TRL",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224089357",
            "telephone_number": "954-881-2169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "JOHANNA",
        "name_prefix": "Ms.",
        "credential": "RIC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-24",
        "last_updated": "2023-08-24",
        "certification_date": "2023-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pedsplus Urgent Care, LLC
• Somdaney Sara Pek, PHARMD
• William Pell III, DDS
• Stephanie Pellar
• Pelorus Counseling and Consulting, LLC
• Kaitlin Ann Pence, BCBA
• Charles G Penick, MD
• Amanda Pensabene, NP
• Hishani Perera, FNP
• Xavier Perez Hernandez, MD

• Professional Counselor in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.