Individual provider Active NPI

Michelle L Johnson, LPC

  • Professional Counselor
  • Tucson, AZ
National Provider Identifier
1811465784
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC-17623 Issued in AZ
Practice address
3902 E Grant Rd
Tucson, AZ 85712-2558
Phone
(520) 468-4801
Fax
(415) 252-7176
NPI assigned
Nov 8, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC-17623 AZ Primary

Addresses

Primary practice location

3902 E Grant Rd
Tucson, AZ 85712-2558

Mailing address

3902 E Grant Rd
Tucson, AZ 85712-2558
Phone (520) 468-4801

Other practice location 1

3939 S Park Ave Ste 150-190
Tucson, AZ 85714-1635
Phone (520) 333-4320

Other identifiers 1

IdentifierTypeStateIssuer
LPC-17623OtherAZSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1 Embarcadero Ctr
FL 19
San Francisco, CA 94111-3628

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC-17623AZMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Community Partners Integrated Healthcare, Inc. PastSince Dec 1, 2020 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1541635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1811465784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3902 E GRANT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122558",
            "telephone_number": "520-468-4801",
            "fax_number": "415-252-7176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3902 E GRANT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122558",
            "telephone_number": "520-468-4801",
            "fax_number": "415-252-7176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3939 S Park Ave Ste 150-190",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857141635",
            "country_code": "US",
            "telephone_number": "520-333-4320",
            "fax_number": "520-207-0542",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MICHELLE",
        "middle_name": "L",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-08",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-17623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "LPC-17623",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.