Family Counseling & Psychological Services LLC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

5460 Issued in FL

Legal business name

FAMILY COUNSELING & PSYCHOLOGICAL SERVICES LLC

Practice address

5422 First Coast Hwy
Ste 119
Amelia Island, FL 32034-5423

Phone

(904) 432-7617

Fax

(904) 432-7088

NPI assigned

Jul 25, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth F. Johnson, DR.

Title

Administrator of Business

Phone

(386) 235-3831

Specialties & licenses 7

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ken Ferrell Johnson Jr., PSYD

  • Mental Health Counselor
  • Amelia Island, FL
  • NPI 1841414547

  Addiction (Substance Use Disorder)

  NPD (past)
• Michele Elizabeth Johnson, LMHC

  • Mental Health Counselor
  • Amelia Island, FL
  • NPI 1649406604
  NPD (past)

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

{
    "created_epoch": "1343174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421798400000",
    "number": "1306192513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5422 FIRST COAST HWY",
            "address_2": "STE 119",
            "city": "AMELIA ISLAND",
            "state": "FL",
            "postal_code": "320345423",
            "telephone_number": "904-432-7617",
            "fax_number": "904-432-7088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5422 FIRST COAST HWY",
            "address_2": "STE 119",
            "city": "AMELIA ISLAND",
            "state": "FL",
            "postal_code": "320345423",
            "telephone_number": "904-432-7617",
            "fax_number": "904-432-7088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY COUNSELING & PSYCHOLOGICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-25",
        "last_updated": "2015-01-21",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "ADMINISTRATOR OF BUSINESS",
        "authorized_official_telephone_number": "386-235-3831",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DR."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "FL",
            "license": "5460",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "5460",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "5548",
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Pastoral",
            "state": "FL",
            "license": "5460",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "FL",
            "license": "5548",
            "primary": false
        },
        {
            "code": "103TE1100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Exercise & Sports",
            "state": "FL",
            "license": "5548",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "MH5548",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Antun, DC
• Amaris Avellan, PH.D.
• Shelley Hicks Botts, CCC/SLP
• Jennifer Renee Carlisle, PTA
• CMZ Chiropractic LLC
• Genesis Eldercare Rehabilitation Services LLC
• Genesis Eldercare Rehabilitation Services LLC
• Jayde Marie Gray, DC
• Gregory N. Smith MD PA
• Ken Ferrell Johnson Jr., PSYD

• Counselor in Amelia Island, FL
• Providers in Amelia Island, FL by specialty
• Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2015; 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.