Jennifer Sue Johnson, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

8136-125 Issued in WI

Practice address

333 E Washington St Ste 2100
West Bend, WI 53095-2503

Phone

(262) 335-4600

Fax

(262) 335-6827

NPI assigned

Jul 20, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Mental Health Counselor

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

County of SheboyganGroup PAC ID 2567568918, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• County of Sheboygan

  • Community/Behavioral Health Agency
  • Sheboygan, WI
  • NPI 1477677615
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1626739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1508439381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 E WASHINGTON ST STE 2100",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530952503",
            "telephone_number": "262-335-4600",
            "fax_number": "262-335-6827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 E WASHINGTON ST STE 2100",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530952503",
            "telephone_number": "262-335-4600",
            "fax_number": "262-335-6827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JENNIFER",
        "middle_name": "SUE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-20",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "8136-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hollister L Jefferson, M.A., SAC-IT
• Katie Ann Jensen, M.A./CFY-SLP
• Keyonta Latrise Johnson- Sims
• Bradley Zenor Johnson, DPT
• Courtney Eileen Johnson
• Lisa L Johnson, P.T.A.
• Mary Johnson, PT
• Matthew Johnson, LPC, SAC-IT
• Shannon Johnson
• Stefanie Johnson, LPC

• Mental Health Counselor in West Bend, WI
• Providers in West Bend, WI by specialty
• Mental Health Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.