Individual provider Active NPI

Taylor Amelia Johnson, LAC

  • Counselor
  • Fayetteville, AR
National Provider Identifier
1831471135
Registry record updated Sep 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
233 W Louise St
Fayetteville, AR 72701-3320
Phone
(501) 658-2542
NPI assigned
Sep 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X AR Primary

Addresses

Primary practice location

233 W Louise St
Fayetteville, AR 72701-3320

Mailing address

2400 S 48TH St
Springdale, AR 72762-6683
Phone (479) 750-2020

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

NPI Registry JSON

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

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315872000000",
    "number": "1831471135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 S 48TH ST",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727626683",
            "telephone_number": "479-750-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 W LOUISE ST",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727013320",
            "telephone_number": "501-658-2542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TAYLOR",
        "middle_name": "AMELIA",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-13",
        "last_updated": "2011-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; 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.