Michael Blaine Johnson, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

3648-125 Issued in WI

Practice address

416 College St
Beloit, WI 53511-6310

Phone

(608) 365-1244

Fax

(608) 365-4097

NPI assigned

Jul 28, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1532736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532736000000",
    "number": "1578041919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1822 CLEVELAND ST",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535112848",
            "telephone_number": "608-436-9182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 COLLEGE ST",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535116310",
            "telephone_number": "608-365-1244",
            "fax_number": "608-365-4097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MICHAEL",
        "middle_name": "BLAINE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-28",
        "last_updated": "2018-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "3648-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42117900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diana Johnson, LPN
• Heather Johnson, LCSW
• Justin D. Johnson, OT
• Ken Johnson, D.D.S.
• Leighton C. Johnson Jr., MD
• Nancy Moe Johnson, PA
• Ryleigh Johnson
• Jolly Counseling and Wellness LLC
• Ashley Lynn Schanmier Jolly, LPC
• Carolyn Ann Jones, N.P.

• Professional Counselor in Beloit, WI
• Providers in Beloit, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2018; 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.