Tatiyana Shauntia Renay Johnson

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

1095 Harcourt Rd
Mount Vernon, OH 43050-4476

Phone

(740) 848-1010

NPI assigned

Jun 1, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Family Life Counseling & Psychiatric Services

  • Addiction (Substance Use Disorder) Counselor
  • Mansfield, OH
  • NPI 1669731246
  NPD (past)

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

{
    "created_epoch": "1685577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1609569946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 ARNOLD AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449032148",
            "telephone_number": "330-275-6594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 HARCOURT RD",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430504476",
            "telephone_number": "740-848-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TATIYANA",
        "middle_name": "SHAUNTIA RENAY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-01",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John R Fowler DDS Inc
• Charla Sue Johnson, LPN
• Gregory Scott Johnson, PSYCHOLOGIST
• Lindsey Johnson
• Raymond Johnson, PA-C
• Dyanna Rae Jones Vess, LPN
• Andrew Jones
• Rachel Jones
• Tammy Joseph, CNP
• Patricia Jubran

• Peer Specialist in Mount Vernon, OH
• Providers in Mount Vernon, OH by specialty
• Peer Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; 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.