Tanya M Johanson, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CC5423 Issued in ME

Practice address

1155 Lisbon St
Lewiston, ME 04240-5025

Phone

(207) 783-9141

Fax

(207) 783-4660

NPI assigned

Apr 9, 2014

Sex

Female

Sole proprietor

No

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

Opted out of Medicare

Yes, effective Apr 3, 2026 through Apr 3, 2028

Medicare enrollment (NPD)

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.

• Kennebec Valley Mental Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waterville, ME
  • NPI 1679504864
  NPD (past)

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

{
    "created_epoch": "1397001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620086400000",
    "number": "1801215520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 LISBON ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042405025",
            "telephone_number": "207-783-9141",
            "fax_number": "207-783-4660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 LISBON ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042405025",
            "telephone_number": "207-783-9141",
            "fax_number": "207-783-4660"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "66 Stone St",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "ME",
            "postal_code": "043305227",
            "country_code": "US",
            "telephone_number": "207-626-3455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHANSON",
        "first_name": "TANYA",
        "middle_name": "M",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-09",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ME",
            "license": "CC5423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor M Jensen
• Phoenix R Jett
• Katherine Jewett
• Lloyd J Jewett, CRNA
• Constantin Jitaru
• John F. Murphy Homes Inc.
• Michael Johns, MD
• David Johnson, MD
• Emily Justine Johnson, M.S., LCPC
• Ryan Johnson, DO

• Professional Counselor in Lewiston, ME
• Providers in Lewiston, ME by specialty
• Professional Counselor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.