Individual provider Active NPI

Johnny Greenhaw, LPCC

  • Addiction (Substance Use Disorder) Counselor
  • Sacramento, CA
National Provider Identifier
1639310261
Registry record updated Nov 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
A020520815 Issued in CA
Practice address
2829 Watt Ave
Sacramento, CA 95821-6200
Phone
(916) 382-6612
NPI assigned
Mar 11, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2025

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 12211 CA
Counselor 101Y00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X A020520815 CA Primary
Case Manager/Care Coordinator 171M00000X
Professional Counselor 101YP2500X LPCC19641 CA
Student in an Organized Health Care Education/Training Program 390200000X
Marriage & Family Therapist 106H00000X LMFT158427 CA

Addresses

Primary practice location

2829 Watt Ave
Sacramento, CA 95821-6200

Mailing address

2829 Watt Ave
Sacramento, CA 95821-6200
Phone (916) 382-6612

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260303004146 CA Practitioner - Mental Health Counselor 8123500741 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5820 Owens Dr
BLDG E2Nd
Pleasanton, CA 94588-3900

5820 Owens Dr BLDG E 2ND Floor
Pleasanton, CA 94588-3900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A020520815CAMDAddiction (Substance Use Disorder) Counselor
LPCC19641CAMDProfessional Counselor
LMFT158427CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc CurrentSince Jan 19, 2026 Accepting new patients
Permanente Medical Group, Inc CurrentSince Jan 19, 2026 Accepting new patients

Locations

2829 Watt Ave
Sacramento, CA 95821
Phone (916) 418-0828

2829 Watt Ave
Ste 150
Sacramento, CA 95821
Phone (916) 482-1132

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1236729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762819200000",
    "number": "1639310261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2829 WATT AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958216200",
            "telephone_number": "916-382-6612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2829 WATT AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958216200",
            "telephone_number": "916-382-6612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENHAW",
        "first_name": "JOHNNY",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-11",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "12211",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "A020520815",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "LPCC19641",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT158427",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.