Staci R Johnson, LMHC, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

14743 Issued in CA

Practice address

7700 Irvine Center Dr Ste 800
Office 32
Irvine, CA 92618-3047

Phone

(317) 316-2787

NPI assigned

Apr 6, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 9, 2024 through Jan 9, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Beacon Pathways

  • Professional Counselor
  • Irvine, CA
  • NPI 1023992211
  NPD Authorized official

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

{
    "created_epoch": "1586131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1619506235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 BOMBAY",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926204806",
            "telephone_number": "317-316-2787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7700 IRVINE CENTER DR STE 800",
            "address_2": "OFFICE 32",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183047",
            "telephone_number": "317-316-2787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "STACI",
        "middle_name": "R",
        "credential": "LMHC, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-06",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39003708A",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "14743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kendra Chideya Johnson
• Kenneth Andrew Johnson, M.D.
• Lori Johnson, PSYD
• Ramona Elizabeth Johnson, M.D.
• Reuben Johnson, D.D.S.
• Trishia Johnson, DDS
• Wendy Johnson
• Lindsey Lee Johnston
• Michele Marie Johnston
• William Roch Johnston, DC

• Mental Health Counselor in Irvine, CA
• Providers in Irvine, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.