Active NPI
Breanna Johnston
- Clinical Psychologist
- Wichita, KS
National Provider Identifier
1427895853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 03293
- Practice address
- 8100 E 22ND St N Ste 100
Wichita, KS 67226-2350 - Phone
- (316) 239-8531
- NPI assigned
- Jul 12, 2024
- Last updated
- Jul 12, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 03293 | KS | Primary |
Addresses
Primary practice location
8100 E 22ND St N Ste 100
Wichita, KS 67226-2350
Mailing address
8100 E 22ND St N Ste 100
Wichita, KS 67226-2350
Phone (316) 239-8531
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
| License | State | Type | Specialty |
|---|---|---|---|
| 03293 | KS | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1720742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720742400000",
"number": "1427895853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8100 E 22ND ST N STE 100",
"city": "WICHITA",
"state": "KS",
"postal_code": "672262350",
"telephone_number": "316-239-8531"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8100 E 22ND ST N STE 100",
"city": "WICHITA",
"state": "KS",
"postal_code": "672262350",
"telephone_number": "316-239-8531"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSTON",
"first_name": "BREANNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-07-12",
"last_updated": "2024-07-12",
"certification_date": "2024-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "KS",
"license": "03293",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.