Jacqueline Johnson

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

3560 Issued in TN

Practice address

325 Ebenezer Rd
Knoxville, TN 37923-5310

Phone

(865) 670-0988

NPI assigned

Mar 4, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Ebenezer Counseling Services

  • Counselor
  • Knoxville, TN
  • NPI 1750430195
  NPD (past)
• Ebenezer Counseling Services

  • Professional Counselor
  • Knoxville, TN
  • NPI 1962703249
  NPD (past)

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

{
    "created_epoch": "1457049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457049600000",
    "number": "1306206297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 EBENEZER RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379235310",
            "telephone_number": "865-670-0988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 EBENEZER RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379235310",
            "telephone_number": "865-670-0988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JACQUELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-04",
        "last_updated": "2016-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "3560",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": "3560",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emmanuel Johnson, B.S.
• Gerald Johnson
• Gerald Dale Johnson
• Glenn D Johnson, D.C.
• Hope Megan Johnson
• James Derek Johnson, CRNA
• Jamie Johnson, DPT
• Jason Eli Johnson, MD
• Jaton Montiek Johnson
• Jeffrey Johnson, M.D.

• Mental Health Counselor in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Mental Health Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2016; 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.