Lisa Johnson

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LCDCIII.161668 Issued in OH

Practice address

5760 Patriot Blvd
Youngstown, OH 44515-1170

Phone

(330) 953-0243

NPI assigned

May 5, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1493942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1497281752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5760 PATRIOT BLVD",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445151170",
            "telephone_number": "330-953-0243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5760 PATRIOT BLVD",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445151170",
            "telephone_number": "330-953-0243"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "960 Boardman Canfield Rd",
            "address_purpose": "LOCATION",
            "city": "Boardman",
            "state": "OH",
            "postal_code": "445124220",
            "country_code": "US",
            "telephone_number": "330-953-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-05",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LCDCIII.161668",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA140689",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kim Johnson, LSW
• Kimberly Johnson
• Kristie Johnson
• Kyle A Johnson, RN
• Lisa Johnson
• Lori Johnson, RN
• Margie Johnson
• Nichole Johnson
• Pamela Johnson, STNA
• Rafeekah Hameeda Johnson

• Addiction (Substance Use Disorder) Counselor in Youngstown, OH
• Providers in Youngstown, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2021; 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.