Active NPI
Andre R Johnson, LCPC, OT
- Professional Counselor
- Gaithersburg, MD
National Provider Identifier
1699111500
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LGP15116
- Practice address
- 9053 Shady Grove CT
Gaithersburg, MD 20877-1301 - Phone
- (240) 810-3790
- NPI assigned
- May 17, 2013
- Last updated
- Jul 17, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LGP15116 | MD | Primary |
| Occupational Therapist | 225X00000X | 03491 | MD |
Addresses
Primary practice location
9053 Shady Grove CT
Gaithersburg, MD 20877-1301
Mailing address
9053 Shady Grove CT
Gaithersburg, MD 20877-1301
Phone (240) 810-3790
Other practice location 1
7717 Pecan Leaf Rd
Severn, MD 21144-6938
Phone (410) 303-2055
Other practice location 2
808 Landmark Dr
Glen Burnie, MD 21061-4983
Phone (667) 600-2516
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71367771 | MD | MD | Professional Counselor |
| 03491 | MD | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Hope Counseling Group, LLC | Professional | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1368748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784246400000",
"number": "1699111500",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9053 SHADY GROVE CT",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "208771301",
"telephone_number": "240-810-3790"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9053 SHADY GROVE CT",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "208771301",
"telephone_number": "240-810-3790"
}
],
"practiceLocations": [
{
"address_1": "7717 Pecan Leaf Rd",
"address_purpose": "LOCATION",
"city": "Severn",
"state": "MD",
"postal_code": "211446938",
"country_code": "US",
"telephone_number": "410-303-2055",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "808 Landmark Dr",
"address_purpose": "LOCATION",
"city": "Glen Burnie",
"state": "MD",
"postal_code": "210614983",
"country_code": "US",
"telephone_number": "667-600-2516",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "ANDRE",
"middle_name": "R",
"credential": "LCPC, OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-05-17",
"last_updated": "2026-07-17",
"certification_date": "2026-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MD",
"license": "LGP15116",
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MD",
"license": "03491",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Gaithersburg, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.