Amy Edwardson Johannesen, M.A., LPC, LMHC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC-5580 Issued in ID

Practice address

504 Main St
Ste. 444
Lewiston, ID 83501-1803

Phone

(208) 750-3000

Fax

(208) 750-1244

NPI assigned

Mar 17, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Sequel Alliance Family Services, LLC

  • Mental Health Counselor
  • Coeur D Alene, ID
  • NPI 1053734251
  NPD (past)

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

{
    "created_epoch": "1426550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426550400000",
    "number": "1780077610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 MAIN ST",
            "address_2": "STE. 444",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835011803",
            "telephone_number": "208-750-3000",
            "fax_number": "208-750-1244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 MAIN ST",
            "address_2": "STE. 444",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835011803",
            "telephone_number": "208-750-3000",
            "fax_number": "208-750-1244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHANNESEN",
        "first_name": "AMY",
        "middle_name": "EDWARDSON",
        "credential": "M.A., LPC, LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-17",
        "last_updated": "2015-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH00005257",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ID",
            "license": "LPC-5580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Billy Gerald Jenkins
• Breanna Kristine Jenks, COTA/L
• Christine A Jensen, MPS,BS,AS
• Levi Jeppson, PA-C
• Joan P Burrow DC LLC
• John J Johnson DDS PC
• John S Kundrat, MD PA
• John T Rietz
• Amy C Johnson, RN
• Amy Dawnette Johnson, RN

• Professional Counselor in Lewiston, ID
• Providers in Lewiston, ID by specialty
• Professional Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2015; 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.