Individual provider Active NPI

Amy Lynne Johnson, LMHC

  • Mental Health Counselor
  • Palm Harbor, FL
National Provider Identifier
1588809396
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH9649 Issued in FL
Practice address
2708 Alt 19 Ste 507-13
Palm Harbor, FL 34683-2634
Phone
(727) 201-2163
NPI assigned
Dec 8, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 10128 NC
Professional Counselor 101YP2500X MH9649 FL
Mental Health Counselor 101YM0800X MH9649 FL Primary

Addresses

Primary practice location

2708 Alt 19 Ste 507-13
Palm Harbor, FL 34683-2634

Mailing address

2708 Alt 19 Ste 507-13
Palm Harbor, FL 34683-2634
Phone (727) 201-2163

Other identifiers 2

IdentifierTypeStateIssuer
MH9649OtherFLSTATE OF FLORIDA LICENSE NUMBER
10128OtherNCNCBLPC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240329002557 FL Practitioner - Mental Health Counselor 6305283797 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2708 Alt
19 Suite 507 13
Palm Harbor, FL 34683-2634

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH9649FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Specialty Group PA Mental Health CurrentSince May 1, 2025 Accepting new patients
Helping Space, LLC Professional CurrentSince Dec 11, 2023 Accepting new patients

Locations

2328 10th Ave N
Ste 201
Lake Worth, FL 33461
Phone (561) 236-7622

2708 Alt 19
Ste 507-13
Palm Harbor, FL 34683
Phone (727) 201-2163

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": "1228694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1588809396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2708 ALT 19 STE 507-13",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346832634",
            "telephone_number": "727-201-2163",
            "fax_number": "727-290-4156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2708 ALT 19 STE 507-13",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346832634",
            "telephone_number": "727-201-2163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "AMY",
        "middle_name": "LYNNE",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-08",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "10128",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "FL",
            "license": "MH9649",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH9649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF FLORIDA LICENSE NUMBER",
            "identifier": "MH9649",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCBLPC",
            "identifier": "10128",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

Verify at the official NPI Registry.