Monty L Moore Johnson, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LCPC-209 Issued in ID

Practice address

6540 W Emerald St
Suite 100
Boise, ID 83704-8782

Phone

(208) 376-0979

Fax

(208) 378-1089

NPI assigned

Feb 14, 2007

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

Other identifiers 2

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.

• Northwest Professionals Family Resource Center

  • Mental Health Counselor
  • Boise, ID
  • NPI 1356564405
  NPD (past) Authorized official

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801939533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44689",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837110689",
            "telephone_number": "208-376-0979",
            "fax_number": "208-378-1089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6540 W EMERALD ST",
            "address_2": "SUITE 100",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048782",
            "telephone_number": "208-376-0979",
            "fax_number": "208-378-1089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE JOHNSON",
        "first_name": "MONTY",
        "middle_name": "L",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LCPC-209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "Q6371",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD OF ID",
            "identifier": "000010145850",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carson A. Mooney, D.D.S.
• Darrel L Mooney, D.D.S. , F.A.C.P.
• Misha Dawn Mooney, L.AC, DIPL. O.M
• Pamela Ellen Mooney
• Roseann T Mooney, D.M.D.
• Moore Wellness PLLC
• Alanna C Moore, PA-C
• Ann Jolene Moore, L.C.P.C.
• Cassandre Lynn Moore, LCSW
• Emily Moore, PA-C

• Mental Health Counselor in Boise, ID
• Providers in Boise, ID by specialty
• Mental Health Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.