Individual provider Active NPI

Victoria B Johnson, LPC

  • Professional Counselor
  • Tempe, AZ
National Provider Identifier
1609053495
Registry record updated Apr 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC-10410 Issued in AZ
Practice address
2120 S McClintock Dr
Ste. 105
Tempe, AZ 85282-2692
Phone
(480) 804-0326
Fax
(480) 804-0083
NPI assigned
Jan 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CPC1041 AZ
Professional Counselor 101YP2500X LPC-10410 AZ Primary

Addresses

Primary practice location

2120 S McClintock Dr
Ste. 105
Tempe, AZ 85282-2692

Mailing address

1400 E Southern Ave
Ste. 735
Tempe, AZ 85282-5691
Phone (480) 804-0326

Other identifiers 1

IdentifierTypeStateIssuer
535278MedicaidAZ

Other names 1

  • Miss Victoria X. Bonapartian Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CPC1041AZMDMental Health Counselor
LPC-10410AZMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1201132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492905600000",
    "number": "1609053495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E SOUTHERN AVE",
            "address_2": "STE. 735",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852825691",
            "telephone_number": "480-804-0326",
            "fax_number": "480-804-0083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 S MCCLINTOCK DR",
            "address_2": "STE. 105",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852822692",
            "telephone_number": "480-804-0326",
            "fax_number": "480-804-0083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "VICTORIA",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-24",
        "last_updated": "2017-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "CPC1041",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-10410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "535278",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICTORIA",
            "last_name": "BONAPARTIAN",
            "middle_name": "X.",
            "prefix": "MISS",
            "credential": "CAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2017; 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.