Individual provider Active NPI

Lindsey Marie Johnson, BCBA

  • Behavior Analyst
  • Mishawaka, IN
National Provider Identifier
1710487020
Registry record updated Oct 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-19-38120
Practice address
1316 W Dragoon TRL
Mishawaka, IN 46544-4713
Phone
(574) 314-4655
NPI assigned
Feb 14, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-19-38120 Primary
Behavior Technician 106S00000X

Addresses

Primary practice location

1316 W Dragoon TRL
Mishawaka, IN 46544-4713

Mailing address

1316 W Dragoon TRL
Mishawaka, IN 46544-4713
Phone (574) 314-0843

Other practice location 1

3948 New Vision Dr Ste D
Fort Wayne, IN 46845-1721
Phone (260) 245-1455

Other practice location 2

12912 Coldwater Rd Ste E
Fort Wayne, IN 46845-8871
Phone (260) 245-1455

Other practice location 3

5750 Falls Dr Ste 102
Fort Wayne, IN 46804-7147
Phone (260) 245-1455

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

Practice roles

OrganizationSpecialtyStatusNew patients
Journeys Behavior Learning Center LLC CurrentSince Nov 17, 2024 Accepting new patients

Locations

1316 W Dragoon Trl
Mishawaka, IN 46544
Phone (574) 855-4292

17106 Cleveland Rd
South Bend, IN 46635
Phone (574) 855-4292

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": "1518566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570406400000",
    "number": "1710487020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1316 W DRAGOON TRL",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465444713",
            "telephone_number": "574-314-0843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1316 W DRAGOON TRL",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465444713",
            "telephone_number": "574-314-4655"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3948 New Vision Dr Ste D",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468451721",
            "country_code": "US",
            "telephone_number": "260-245-1455",
            "fax_number": "317-815-3861",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12912 Coldwater Rd Ste E",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468458871",
            "country_code": "US",
            "telephone_number": "260-245-1455",
            "fax_number": "317-815-3861",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5750 Falls Dr Ste 102",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468047147",
            "country_code": "US",
            "telephone_number": "260-245-1455",
            "fax_number": "317-815-3861",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LINDSEY",
        "middle_name": "MARIE",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-14",
        "last_updated": "2019-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-19-38120",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mishawaka, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2019; 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.