NPIMap

Organization Active NPI

Living Hope Christian Counseling

  • Professional Counselor
  • De Pere, WI
National Provider Identifier
1720026107
Registry record updated Sep 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
1752 Issued in WI
Legal business name
LIVING HOPE CHRISTIAN COUNSELING
Practice address
2066 Lawrence Dr
De Pere, WI 54115-9421
Phone
(920) 338-8699
NPI assigned
Jun 4, 2006
Last updated
Sep 9, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2007

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

Authorized official

Name
John Carl Johnson, PHD
Title
Psychologist
Phone
(920) 338-8699

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 1752 WI Primary

Addresses

Primary practice location

2066 Lawrence Dr
De Pere, WI 54115-9421

Mailing address

2066 Lawrence Dr
De Pere, WI 54115-9421
Phone (920) 338-8699

Other identifiers 1

IdentifierTypeStateIssuer
41005200MedicaidWI

National Provider Directory

National Provider Directory

Locations

2066 Lawrence Dr
De Pere, WI 54115
Phone (920) 338-8699

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189296000000",
    "number": "1720026107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2066 LAWRENCE DR",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541159421",
            "telephone_number": "920-338-8699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2066 LAWRENCE DR",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541159421",
            "telephone_number": "920-338-8699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING HOPE CHRISTIAN COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2007-09-09",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "CARL",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "920-338-8699",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "1752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41005200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in De Pere, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2007; 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.