Individual provider Active NPI

Virginia Lynn Johnson, LPC

  • Professional Counselor
  • Du Bois, PA
National Provider Identifier
1649787433
Registry record updated Jan 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC010122 Issued in PA
Practice address
26 Harold Bundy Rd
Du Bois, PA 15801-7132
Phone
(814) 590-9988
NPI assigned
Jan 3, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PC010122 PA Primary

Addresses

Primary practice location

26 Harold Bundy Rd
Du Bois, PA 15801-7132

Mailing address

26 Harold Bundy Rd
Du Bois, PA 15801-7132
Phone (814) 590-9988

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20241212000120 PA Practitioner - Mental Health Counselor 8527418391

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PC010122PAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Cen Clear Child Services, Inc. CurrentSince Apr 14, 2024 Accepting new patients

Locations

50 Bigler Rd
Woodland, PA 16881

Organizations & group practices 1

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": "1514937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514937600000",
    "number": "1649787433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 HAROLD BUNDY RD",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158017132",
            "telephone_number": "814-590-9988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 HAROLD BUNDY RD",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158017132",
            "telephone_number": "814-590-9988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "VIRGINIA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-03",
        "last_updated": "2018-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC010122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Du Bois, PA

Sources for this page

Verify at the official NPI Registry.