Individual provider Active NPI

Russell H Johnson, LCMHC

  • Mental Health Counselor
  • Manchester, NH
National Provider Identifier
1457439853
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
293 Issued in NH
Practice address
2 Wall St
Suite 300
Manchester, NH 03101-1518
Phone
(603) 668-4111
Fax
(603) 628-7757
NPI assigned
Nov 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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 293 NH Primary

Addresses

Primary practice location

2 Wall St
Suite 300
Manchester, NH 03101-1518

Mailing address

2 Wall St Ste 300
Manchester, NH 03101-1518
Phone (603) 668-4111

Other identifiers 3

IdentifierTypeStateIssuer
2017883OtherNHCIGNA
020258994-47OtherNHHARVARD PILGRIM
1409411Y0NH03OtherNHBLUE CROSS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address TheMentalHealthCenterofGreaterManchester@mhcgm.netsmartdirect.net Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240102000701 NH Practitioner - Mental Health Counselor 4183074206 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Mental Health Center of Greater ManchesterGroup PAC ID 6709874274, 86 clinicians

Practice addresses (Care Compare)

2 Wall St
Manchester, NH 03101-1518
Phone (603) 668-4111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
293NHMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Mental Health Center of Greater Manchester CurrentSince Jan 1, 2024 Accepting new patients

Locations

2 Wall St
Ste 300
Manchester, NH 03101
Phone (603) 668-1111

2 Wall St
Manchester, NH 03101
Phone 6036684111 ext. 6900

401 Cypress St
Manchester, NH 03103
Phone (603) 206-8586

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": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1457439853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WALL ST STE 300",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031011518",
            "telephone_number": "603-668-4111",
            "fax_number": "603-628-7757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 WALL ST",
            "address_2": "SUITE 300",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031011518",
            "telephone_number": "603-668-4111",
            "fax_number": "603-628-7757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RUSSELL",
        "middle_name": "H",
        "credential": "LCMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NH",
            "license": "293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2017883",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "020258994-47",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "1409411Y0NH03",
            "state": "NH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "TheMentalHealthCenterofGreaterManchester@mhcgm.netsmartdirect.net",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2 Wall St",
            "address_2": "Suite 300",
            "city": "Manchester",
            "state": "NH",
            "country_code": "US",
            "postal_code": "031011518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.