Individual provider Active NPI

Kelsey Joy-Marie Johnson

  • Professional Counselor
  • Lancaster, OH
National Provider Identifier
1609251115
Registry record updated Aug 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E.1800795-SUPV Issued in OH
Practice address
624 E Main St
Lancaster, OH 43130
Phone
(740) 687-0042
NPI assigned
Jul 26, 2015
Last updated
Aug 5, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2019

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 E.1800795 OH
Professional Counselor 101YP2500X E2722-S OH
Professional Counselor 101YP2500X E.1800795-SUPV OH Primary

Addresses

Primary practice location

624 E Main St
Lancaster, OH 43130

Mailing address

624 E Main St
Lancaster, OH 43130-3903
Phone (740) 687-0042

Other practice location 1

625 N Sandusky Ave
Upper Sandusky, OH 43351-1037
Phone (419) 294-5795

Other practice location 2

68 W Church St
Newark, OH 43055-5050
Phone (740) 281-1777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E.1800795OHMDProfessional Counselor
E.1800795-SUPVOHMDProfessional Counselor
E2722-SOHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Usc&LC LLC Professional PastSince Jan 24, 2021 Accepting new patients
Pathways Counseling Center Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1437868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564963200000",
    "number": "1609251115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 E MAIN ST",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431303903",
            "telephone_number": "740-687-0042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 E MAIN ST",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "43130",
            "telephone_number": "740-687-0042"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "625 N Sandusky Ave",
            "address_purpose": "LOCATION",
            "city": "Upper Sandusky",
            "state": "OH",
            "postal_code": "433511037",
            "country_code": "US",
            "telephone_number": "419-294-5795",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "68 W Church St",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "OH",
            "postal_code": "430555050",
            "country_code": "US",
            "telephone_number": "740-281-1777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KELSEY",
        "middle_name": "JOY-MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-26",
        "last_updated": "2019-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.1800795",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E2722-S",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.1800795-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, OH

Sources for this page

Verify at the official NPI Registry.