Active NPI
Kirsten Johnson
- Mental Health Counselor
- Orlando, FL
National Provider Identifier
1457616484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 14989
- Practice address
- 3544 Edgewater Dr
Orlando, FL 32804-2922 - Phone
- (407) 291-8009
- NPI assigned
- Jul 5, 2012
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 14989 | FL | Primary |
Addresses
Primary practice location
3544 Edgewater Dr
Orlando, FL 32804-2922
Mailing address
3544 Edgewater Dr
Orlando, FL 32804-2922
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1300881 | Medicaid | MA |
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 |
|---|---|---|---|
| 14989 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491523200000",
"number": "1457616484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3544 EDGEWATER DR",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328042922"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3544 EDGEWATER DR",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328042922",
"telephone_number": "407-291-8009"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "KIRSTEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-05",
"last_updated": "2017-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "14989",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1300881",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.