Active NPI
Katerra Lee Miller Johnson
- Mental Health Counselor
- Omaha, NE
National Provider Identifier
1790295574
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 12698
- Practice address
- 6902 Pine St
Omaha, NE 68106-2855 - Phone
- (402) 559-6408
- Fax
- (402) 559-5737
- NPI assigned
- Oct 5, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Mental Health Counselor | 101YM0800X | 12698 | NE | Primary |
Addresses
Primary practice location
6902 Pine St
Omaha, NE 68106-2855
Mailing address
6902 Pine St
Omaha, NE 68106-2855
Phone (402) 559-6408
Other practice location 1
4460 S Highland Dr Ste 230
Salt Lake City, UT 84124-3550
Phone (801) 263-7227
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12698 | NE | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626739200000",
"number": "1790295574",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6902 PINE ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681062855",
"telephone_number": "402-559-6408",
"fax_number": "402-559-5737"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6902 PINE ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681062855",
"telephone_number": "402-559-6408",
"fax_number": "402-559-5737"
}
],
"practiceLocations": [
{
"address_1": "4460 S Highland Dr Ste 230",
"address_purpose": "LOCATION",
"city": "Salt Lake City",
"state": "UT",
"postal_code": "841243550",
"country_code": "US",
"telephone_number": "801-263-7227",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "KATERRA",
"middle_name": "LEE MILLER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-10-05",
"last_updated": "2021-07-20",
"certification_date": "2021-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NE",
"license": "12698",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.