Individual provider Active NPI

Andre R Johnson, LCPC, OT

  • Professional Counselor
  • Gaithersburg, MD
National Provider Identifier
1699111500
Registry record updated Jul 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LGP15116 Issued in MD
Practice address
9053 Shady Grove CT
Gaithersburg, MD 20877-1301
Phone
(240) 810-3790
NPI assigned
May 17, 2013
Last updated
Jul 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
71367771MDMDProfessional Counselor
03491MDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
New Hope Counseling Group, LLC Professional PastSince Sep 1, 2024 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.

Verify at the official NPI Registry.