Individual provider Active NPI

Kristie Lynn Johnson, CP61134159

  • Addiction (Substance Use Disorder) Counselor
  • Spokane, WA
National Provider Identifier
1447895602
Registry record updated Nov 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CP61134159 Issued in WA
Practice address
22 S Thor St
Spokane, WA 99202-4855
Phone
(509) 532-2000
Fax
(509) 532-2005
NPI assigned
Nov 12, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CP61134159 WA Primary

Addresses

Primary practice location

22 S Thor St
Spokane, WA 99202-4855

Mailing address

Walla Walla State Penitentiary
1313 N 13TH Ave
Walla Walla, WA 99362
Phone (509) 524-7509

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
CP61134159WAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Yfa Connections Addiction (Substance Use Disorder) CurrentSince Nov 24, 2025 Accepting new patients
Pioneer Human Services PastSince Jan 19, 2025 Accepting new patients
The Valley Alcohol Council PastSince Nov 1, 2019 Accepting new patients

Locations

22 S Thor St
Spokane, WA 99202
Phone (509) 532-2000

Organizations & group practices 3

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": "1573516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763337600000",
    "number": "1447895602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "WALLA WALLA STATE PENITENTIARY",
            "address_2": "1313 N 13TH AVE",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "99362",
            "telephone_number": "509-524-7509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S THOR ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992024855",
            "telephone_number": "509-532-2000",
            "fax_number": "509-532-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KRISTIE",
        "middle_name": "LYNN",
        "credential": "CP61134159",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-12",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP61134159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2025; 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.