Individual provider Active NPI

Johnny P Nguyen, LMHC

  • Mental Health Counselor
  • Tampa, FL
National Provider Identifier
1770816738
Registry record updated Jan 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH17441 Issued in FL
Practice address
10002 Forest Hills Dr
Tampa, FL 33612-7768
Phone
(813) 906-9064
Fax
(813) 462-2912
NPI assigned
Sep 9, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH17441 FL Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X MH17441 FL
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

10002 Forest Hills Dr
Tampa, FL 33612-7768

Mailing address

10002 Forest Hills Dr
Tampa, FL 33612-7768
Phone (813) 906-9064

Other practice location 1

1930 Market St
San Francisco, CA 94102-6228
Phone (415) 476-3902

Other practice location 2

1009 Maitland Center Commons Blvd Ste 212
Maitland, FL 32751-7270
Phone (800) 840-2528

Other identifiers 2

IdentifierTypeStateIssuer
MH17441OtherFLSTATE LICENSE
104740300MedicaidFL

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
MH17441FLMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Psychamerica Behavioral Services LLC Mental Health CurrentSince Jan 12, 2020 Accepting new patients

Locations

10002 Forest Hills Dr
Tampa, FL 33612
Phone (800) 840-2528

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": "1252454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578528000000",
    "number": "1770816738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10002 FOREST HILLS DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336127768",
            "telephone_number": "813-906-9064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10002 FOREST HILLS DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336127768",
            "telephone_number": "813-906-9064",
            "fax_number": "813-462-2912"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1930 Market St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941026228",
            "country_code": "US",
            "telephone_number": "415-476-3902",
            "fax_number": "415-502-7240",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1009 Maitland Center Commons Blvd Ste 212",
            "address_purpose": "LOCATION",
            "city": "Maitland",
            "state": "FL",
            "postal_code": "327517270",
            "country_code": "US",
            "telephone_number": "800-840-2528",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JOHNNY",
        "middle_name": "P",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-09",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH17441",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "MH17441",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "MH17441",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104740300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2020; 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.