Jennifer Lynn Johnson, ATR-BC,L-CAT

Primary specialty

Art TherapistTaxonomy code 221700000X

License

000775-1 Issued in NY

Practice address

Nichols Rd
Stony Brook, NY 11794-0001

Phone

(631) 444-1051

NPI assigned

Feb 14, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jennifer Lynn Hacker Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1392336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392336000000",
    "number": "1669896403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 LAKE SHORE DR",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117793154",
            "telephone_number": "631-648-8740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NICHOLS RD",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117940001",
            "telephone_number": "631-444-1051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "ATR-BC,L-CAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-14",
        "last_updated": "2014-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": "NY",
            "license": "000775-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "HACKER",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• John G. Cottone, Psychologist, PLLC
• John Tsouris, DPM
• Roshen John, MD
• Kaitlin Johnsen, DO
• Amy R Johnson, DPT
• Scott Johnson, M.D.
• Margaret Johnstone, M.D.
• Steven Jonas, MD
• Evan C Jones, M.D.
• Joseph Jones, M.D.

• Art Therapist in Stony Brook, NY
• Providers in Stony Brook, NY by specialty
• Art Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2014; 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.