Johanna Villasenor Nardini, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

MD61413990 Issued in WA

Practice address

4405 7TH Ave SE Ste 200
Lacey, WA 98503-1055

Phone

(210) 201-2656

NPI assigned

Mar 27, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Nov 12, 2025 through Nov 12, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Bravo Mind Psychiatry PLLC

  • Adolescent and Children Mental Health Clinic/Center
  • Lacey, WA
  • NPI 1982440400
  NPD Authorized official
• Coastal Plains Community MHMR Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Portland, TX
  • NPI 1194104026
  NPD (past)

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

{
    "created_epoch": "1459036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1780046839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13423 BLANCO RD UNIT 3164",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782162187",
            "telephone_number": "201-210-2656",
            "fax_number": "863-228-8489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 7TH AVE SE STE 200",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985031055",
            "telephone_number": "210-201-2656"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3857 Martin Way E",
            "address_purpose": "LOCATION",
            "city": "Olympia",
            "state": "WA",
            "postal_code": "985065268",
            "country_code": "US",
            "telephone_number": "360-704-7170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NARDINI",
        "first_name": "JOHANNA",
        "middle_name": "VILLASENOR",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-27",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TX",
            "license": "T0115",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "T0115",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "MD61413990",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "WA",
            "license": "MD61413990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jane Suechung Myung, MD
• Abigail Namocatcat
• Lyndsay Gay Naour, LMP
• National Seating & Mobility, Inc.
• National Vision, Inc.
• Natural Medicines & Family Practice
• Otniel Navarrete
• Navreet Kaur PLLC

• Child & Adolescent Psychiatry Physician in Lacey, WA
• Providers in Lacey, WA by specialty
• Child & Adolescent Psychiatry Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.