Mandy Lynn Johnson, PEER SUPPORT SPECIAL

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

113576 Issued in OR

Practice address

36542 Highway 58
Pleasant Hill, OR 97455-9689

Phone

(541) 606-2919

NPI assigned

Mar 22, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Silly Billies Cares

  • Peer Specialist
  • Pleasant Hill, OR
  • NPI 1154268571
  NPD Authorized official

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

{
    "created_epoch": "1742601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742601600000",
    "number": "1780485094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36542 HIGHWAY 58",
            "city": "PLEASANT HILL",
            "state": "OR",
            "postal_code": "974559689",
            "telephone_number": "541-606-2919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36542 HIGHWAY 58",
            "city": "PLEASANT HILL",
            "state": "OR",
            "postal_code": "974559689",
            "telephone_number": "541-606-2919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MANDY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PEER SUPPORT SPECIAL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-22",
        "last_updated": "2025-03-22",
        "certification_date": "2025-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "113576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Cox Hammond, RN/FNP
• David Harries
• Kennedy Hildebrand
• Icco LLC
• Icco LLC
• Kimberly Lamborn
• Irilla Mae Lemaster
• Helene K Lichtman, LPC, NCC, CCMHC
• Morgan Lyddane
• Kimberly G Metzler, LMT

• Peer Specialist in Pleasant Hill, OR
• Providers in Pleasant Hill, OR by specialty
• Peer Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2025; 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.