Kelley A Johnston

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LC4577 Issued in ME

Practice address

147 Academy St
Presque Isle, ME 04769-3101

Phone

(207) 764-6825

Fax

(207) 764-6077

NPI assigned

Sep 19, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Life by Design, PA

  • Clinical Social Worker
  • Presque Isle, ME
  • NPI 1053345918
  NPD
• Micmac Health Department

  • Community Health Clinic/Center
  • Presque Isle, ME
  • NPI 1881232346
  NPD
• Aroostook Mental Health Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Presque Isle, ME
  • NPI 1487601399
  NPD (past)
• Life by Design

  • Health Maintenance Organization
  • Caribou, ME
  • NPI 1316222037
  NPD (past)

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570406400000",
    "number": "1740476159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 509",
            "city": "PRESQUE ISLE",
            "state": "ME",
            "postal_code": "047690509",
            "telephone_number": "207-764-6825",
            "fax_number": "207-764-6077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 ACADEMY ST",
            "city": "PRESQUE ISLE",
            "state": "ME",
            "postal_code": "047693101",
            "telephone_number": "207-764-6825",
            "fax_number": "207-764-6077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "KELLEY",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-19",
        "last_updated": "2019-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ME",
            "license": "CAC3787",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ME",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ME",
            "license": "LC4577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1740476159",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allen Irvin Jacobs, D.M.D.
• Gabrielle Jandreau, MSOTR/L
• Stacy-Jo W. Jandreau, MD
• Erik Arthur Johnson, DMD
• Dylan Royce Johnston, PHARMD
• Tiffany P Johnston, SLP
• Deborah J Jones, FNP
• Laura J. Jordan, CRNA
• Jason Alan Kaiser, MD
• Felicite Mbombo Kamba, LD

• Addiction (Substance Use Disorder) Counselor in Presque Isle, ME
• Providers in Presque Isle, ME by specialty
• Addiction (Substance Use Disorder) Counselor in Maine

• 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.