Individual provider Active NPI

Kimberly Johnson

  • Professional Counselor
  • Enfield, CT
National Provider Identifier
1275846131
Registry record updated Apr 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
153 Hazard Ave
Enfield, CT 06082-4592
Phone
(860) 253-5020
NPI assigned
Jul 21, 2010
Last updated
Apr 11, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NU Primary
Behavior Analyst 103K00000X NU

Addresses

Primary practice location

153 Hazard Ave
Enfield, CT 06082-4592

Mailing address

995 Day Hill Rd
Windsor, CT 06095-1722
Phone (860) 731-5522

Other practice location 1

435 Buckland Rd
South Windsor, CT 06074-3720
Phone (860) 436-0850

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

NPI Registry JSON

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

{
    "created_epoch": "1279670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554940800000",
    "number": "1275846131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "995 DAY HILL RD",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060951722",
            "telephone_number": "860-731-5522",
            "fax_number": "860-731-5526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 HAZARD AVE",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060824592",
            "telephone_number": "860-253-5020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "435 Buckland Rd",
            "address_purpose": "LOCATION",
            "city": "South Windsor",
            "state": "CT",
            "postal_code": "060743720",
            "country_code": "US",
            "telephone_number": "860-436-0850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KIMBERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-21",
        "last_updated": "2019-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2019; 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.