Kathleen Noel Johnson, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH23756 Issued in FL

Practice address

2055 Reyko Rd Ste 100
Jacksonville, FL 32207-2822

Phone

(904) 648-8200

NPI assigned

May 16, 2024

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

Other names 1

• Stephanie Katelyn Moroney Former name

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

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.

• Dna Comprehensive Therapy Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Myers, FL
  • NPI 1316363757
  Medicare reassignment NPD
• Bonita Springs Retirement Village, Inc.

  • Skilled Nursing Facility
  • Bonita Springs, FL
  • NPI 1700126802
  NPD

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

{
    "created_epoch": "1715817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1316796857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11636 STARFISH AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322463917",
            "telephone_number": "571-430-0983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 REYKO RD STE 100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322072822",
            "telephone_number": "904-648-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KATHLEEN",
        "middle_name": "NOEL",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-16",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH23756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "MORONEY",
            "middle_name": "KATELYN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joseph Ethan Johnson, BA
• Jquinn Johnson
• Julieann Johnson, PA
• Kaitlyn Johnson, PA-C
• Kasie Lynn Johnson
• Katrina M Johnson
• Kenneth Johnson
• Kenya Frederick Johnson, PHARMD
• Kiara Atheria Johnson
• Kimberly Ann Johnson

• Mental Health Counselor in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.