Individual provider Active NPI

Kejuiana L. Johnson

  • Professional Counselor
  • Hinesville, GA
National Provider Identifier
1811306814
Registry record updated Jul 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
009587 Issued in GA
Practice address
407 N Main St
Hinesville, GA 31313-2509
Phone
(678) 664-4003
NPI assigned
Aug 5, 2014
Last updated
Jul 11, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 004421 GA
Professional Counselor 101YP2500X 009587 GA Primary

Addresses

Primary practice location

407 N Main St
Hinesville, GA 31313-2509

Mailing address

PO Box 1417
Hinesville, GA 31310-8417

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
004421GAMDCounselor
009587GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ga Integrated Therapeutic Perspectives Current Accepting new patients
Teladoc Health Medical Group, P.a. Counselor Current Accepting new patients
Generations to Come Center LLC. Current Accepting new patients

Locations

407 N Main St
Hinesville, GA 31313
Phone (678) 664-4003

Interoperability endpoints

  • Direct secure messaging: kejuianajohnson@tdh.allscriptsdirect.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1407196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499731200000",
    "number": "1811306814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1417",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313108417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 N MAIN ST",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313132509",
            "telephone_number": "678-664-4003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KEJUIANA",
        "middle_name": "L.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-05",
        "last_updated": "2017-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "GA",
            "license": "004421",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "009587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hinesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2017; 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.