Individual provider Active NPI

Kimberly Ross Johnson, LMFT

  • Marriage & Family Therapist
  • Darien, CT
National Provider Identifier
1538526231
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1763 Issued in CT
Practice address
30 Old Kings Hwy S
Darien, CT 06820-4526
Phone
(203) 978-3000
NPI assigned
Jan 26, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 1763 CT Primary

Addresses

Primary practice location

30 Old Kings Hwy S
Darien, CT 06820-4526

Mailing address

30 Old Kings Hwy S
Darien, CT 06820-4526
Phone (203) 978-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20240731002742 CT Practitioner - Marriage and Family Therapist 3476090044 Practice locations: Darien, CT

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

30 Old Kings Hwy S
Suite 212
Darien, CT 06820-4526
Phone (203) 978-3000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1453766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1538526231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 OLD KINGS HWY S",
            "city": "DARIEN",
            "state": "CT",
            "postal_code": "068204526",
            "telephone_number": "203-978-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 OLD KINGS HWY S",
            "city": "DARIEN",
            "state": "CT",
            "postal_code": "068204526",
            "telephone_number": "203-978-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KIMBERLY",
        "middle_name": "ROSS",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-26",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "1763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Darien, CT

Sources for this page

Verify at the official NPI Registry.