Individual provider Active NPI

Lisa Carle Johnson, COUNSELOR

  • Mental Health Counselor
  • Tacoma, WA
National Provider Identifier
1417296294
Registry record updated Feb 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CG 60248031 Issued in WA
Practice address
1305 Tacoma Ave S Ste 305
Tacoma, WA 98402-1903
Phone
(253) 396-5000
NPI assigned
Feb 13, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CG 60248031 WA Primary

Addresses

Primary practice location

1305 Tacoma Ave S Ste 305
Tacoma, WA 98402-1903

Mailing address

PO Box 65653
Tacoma, WA 98464-1653
Phone (253) 396-5000

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

State licenses

LicenseStateTypeSpecialty
CG 60248031WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Mental Health Center of Tacoma-Pierce County PastSince Oct 10, 2017 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1360713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360713600000",
    "number": "1417296294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 65653",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984641653",
            "telephone_number": "253-396-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 TACOMA AVE S STE 305",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984021903",
            "telephone_number": "253-396-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LISA",
        "middle_name": "CARLE",
        "name_prefix": "Ms.",
        "credential": "COUNSELOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-13",
        "last_updated": "2013-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "CG 60248031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2013; 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.