Johanna Reicks, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

20443 Issued in FL

Practice address

1011 N 12TH Ave
Pensacola, FL 32501-3306

Phone

(850) 250-1441

NPI assigned

Jul 27, 2019

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

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.

• Mended Wing Counseling, LLC

  • Mental Health Counselor
  • Pensacola, FL
  • NPI 1679980098
  NPD

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

{
    "created_epoch": "1564185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1629622782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 N 12TH AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325013306",
            "telephone_number": "850-250-1441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 N 12TH AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325013306",
            "telephone_number": "850-250-1441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REICKS",
        "first_name": "JOHANNA",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-27",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "20443",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rehabilitation Center at Park Place, LLC
• Swaiyah Rehman
• Eliyahu Pesach Reich, PH.D.
• Katelyn Rae Reichardt, MS, RDN, LDN, CNSC
• Brett David Reichwage
• Amber Rose Reid
• Christopher S Reid, MD
• Douglas Craig Reid
• Patrick Francis Reilly, MD
• Elizabeth Ann Rein, D.C.

• Mental Health Counselor in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; 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.