Individual provider Active NPI

Katerra Lee Miller Johnson

  • Mental Health Counselor
  • Omaha, NE
National Provider Identifier
1790295574
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
12698 Issued in NE
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

Updated by the provider on Jul 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
12698NEMDPharmacist

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.

Verify at the official NPI Registry.