Individual provider Active NPI

Coral Lynn Johnson, LPCC, PPS

  • Mental Health Counselor
  • Covina, CA
National Provider Identifier
1417866112
Registry record updated Sep 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPCC21251 Issued in CA
Practice address
1109 W San Bernardino Rd Ste 150
Covina, CA 91722-4156
Phone
(626) 541-0009
NPI assigned
Sep 7, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X LPCC21251 CA Primary

Addresses

Primary practice location

1109 W San Bernardino Rd Ste 150
Covina, CA 91722-4156

Mailing address

1303 Maywood Ave
Upland, CA 91786-2542
Phone (626) 541-0009

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788739200000",
    "number": "1417866112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 MAYWOOD AVE",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917862542",
            "telephone_number": "626-541-0009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 W SAN BERNARDINO RD STE 150",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917224156",
            "telephone_number": "626-541-0009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CORAL",
        "middle_name": "LYNN",
        "credential": "LPCC, PPS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-07",
        "last_updated": "2026-09-07",
        "certification_date": "2026-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "LPCC21251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.