Individual provider Active NPI

Pamela Johnson, M.ED.,PCC-S

  • Professional Counselor
  • Waverly, OH
National Provider Identifier
1679711386
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E2779 Issued in OH
Practice address
218 E North St
Waverly, OH 45690-1148
Phone
(740) 981-6513
NPI assigned
Feb 3, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 110117 OH
Mental Health Counselor 101YM0800X E2779 OH
Professional Counselor 101YP2500X E2779 OH Primary

Addresses

Primary practice location

218 E North St
Waverly, OH 45690-1148

Mailing address

PO Box 226
Waverly, OH 45690
Phone (740) 981-6513

Other practice location 1

1634 11th St
Portsmouth, OH 45662-4526
Phone (740) 354-6685

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
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
110117OHMDAddiction (Substance Use Disorder) Counselor
E2779OHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Pike County Recovery Council Inc CurrentSince Jul 24, 2022 Accepting new patients
Pike County Recovery Council Inc CurrentSince Jul 24, 2022 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/PikeCounty/r4/

Organizations & group practices 2

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": "1233619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1679711386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 226",
            "city": "WAVERLY",
            "state": "OH",
            "postal_code": "45690",
            "telephone_number": "740-981-6513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 E NORTH ST",
            "city": "WAVERLY",
            "state": "OH",
            "postal_code": "456901148",
            "telephone_number": "740-981-6513"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1634 11th St",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "OH",
            "postal_code": "456624526",
            "country_code": "US",
            "telephone_number": "740-354-6685",
            "fax_number": "740-354-5061",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "PAMELA",
        "credential": "M.ED.,PCC-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "110117",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E2779",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E2779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waverly, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.