Susan Renee Johnson, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0701005349 Issued in VA

Practice address

19056 Greenbush Road
Parksley, VA 23421

Phone

(757) 665-1260

Fax

(757) 665-4184

NPI assigned

Aug 31, 2016

Last updated

Mar 17, 2018By the provider in NPPES

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

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, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eastern Shore Community MH Mr Sas Services BoardGroup PAC ID 8729185095, 17 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Eastern Shore Community MH Mr Sas Services Board

  dba Eastern Shore Behavioral Healthcare Center

  • Professional Counselor
  • Parksley, VA
  • NPI 1154411510
  Medicare reassignment Care Compare group NPD
• Eastern Shore Community Services Board

  • Speech-Language Pathologist
  • Belle Haven, VA
  • NPI 1821283722
  NPD

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

{
    "created_epoch": "1472601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1275089930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1330",
            "city": "PARKSLEY",
            "state": "VA",
            "postal_code": "234211330",
            "telephone_number": "757-665-1260",
            "fax_number": "757-665-4184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19056 GREENBUSH ROAD",
            "city": "PARKSLEY",
            "state": "VA",
            "postal_code": "23421",
            "telephone_number": "757-665-1260",
            "fax_number": "757-665-4184"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23322 Courthouse Ave",
            "address_2": "PO Box 938",
            "address_purpose": "LOCATION",
            "city": "Accomac",
            "state": "VA",
            "postal_code": "233010938",
            "country_code": "US",
            "telephone_number": "757-709-4722",
            "fax_number": "844-563-6080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SUSAN",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-31",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701005349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Dize Franklin, CCC-SLP
• Lori Birch Graham, LPC
• Edward Nicholas Griggs III, D.D.S.
• Hospice Care of the Eastern Shore, Inc. (Hospice and Palliative Care of the Eastern Shore, Inc.)
• Jennica Huether
• Monica Boole Layne, FNP
• Deborah Linnell, LPC
• Laura Lungarelli, LCSW
• Holly Lynn Matthews, FNP
• Ann McAdams

• Mental Health Counselor in Parksley, VA
• Providers in Parksley, VA by specialty
• Mental Health Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.