Individual provider Active NPI

Brenda Ranae Johnston, LBSW, LPC

  • Professional Counselor
  • Amarillo, TX
National Provider Identifier
1467778209
Registry record updated May 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
72336 Issued in TX
Practice address
2505 Lakeview Dr Ste 203
Amarillo, TX 79109-1525
Phone
(806) 790-5152
Fax
(806) 240-9768
NPI assigned
Apr 19, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 39613 TX
Professional Counselor 101YP2500X 72336 TX Primary

Addresses

Primary practice location

2505 Lakeview Dr Ste 203
Amarillo, TX 79109-1525

Mailing address

2505 Lakeview Dr Ste 203
Amarillo, TX 79109-1525
Phone (806) 790-5152

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240710005275 TX Practitioner - Mental Health Counselor 6305381690 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2505 Lakeview Dr
Suite 203
Amarillo, TX 79109-1525
Phone (806) 790-5152

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
72336TXMDProfessional Counselor
39613TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Altering Ways LLC Professional CurrentSince May 15, 2024 Accepting new patients
Teladoc Health Medical Group, P.a. Professional Current Accepting new patients

Locations

2505 Lakeview Dr
Ste 203
Amarillo, TX 79109
Phone (806) 790-5152

Interoperability endpoints

  • Direct secure messaging: brendacantu@tdh.allscriptsdirect.net

Organizations & group practices 2

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": "1271635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1467778209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 LAKEVIEW DR STE 203",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791091525",
            "telephone_number": "806-790-5152",
            "fax_number": "806-240-9768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 LAKEVIEW DR STE 203",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791091525",
            "telephone_number": "806-790-5152",
            "fax_number": "806-240-9768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "BRENDA",
        "middle_name": "RANAE",
        "name_prefix": "Ms.",
        "credential": "LBSW, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-19",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TX",
            "license": "39613",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "72336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

Verify at the official NPI Registry.