Active NPI
Diane Wilson Johnson, LCMHC
- Mental Health Counselor
- Conway, NH
National Provider Identifier
1629170410
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 90
- Practice address
- 30 Pleasant Street
Conway, NH 03818-1114 - Phone
- (603) 447-2239
- Fax
- (603) 447-2239
- NPI assigned
- Sep 2, 2006
- Last updated
- Dec 18, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 90 | NH | Primary |
Addresses
Primary practice location
30 Pleasant Street
Conway, NH 03818-1114
Mailing address
PO Box 1114
30 Pleasant St
Conway, NH 03818-1114
Phone (603) 447-2239
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30009004 | Medicaid | NH |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 90 | NH | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1387324800000",
"number": "1629170410",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1114",
"address_2": "30 PLEASANT ST",
"city": "CONWAY",
"state": "NH",
"postal_code": "038181114",
"telephone_number": "603-447-2239",
"fax_number": "603-447-2239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 PLEASANT STREET",
"city": "CONWAY",
"state": "NH",
"postal_code": "038181114",
"telephone_number": "603-447-2239",
"fax_number": "603-447-2239"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "DIANE",
"middle_name": "WILSON",
"credential": "LCMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-02",
"last_updated": "2013-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NH",
"license": "90",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30009004",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Conway, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.