Jesse Johnson, LPC/MHSP

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

4913 Issued in TN

Practice address

4 Rebel CV
Jackson, TN 38301-7707

Phone

(731) 234-2165

NPI assigned

Apr 22, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Impact Behavioral Counseling LLCGroup PAC ID 1355604836, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Impact Behavioral Counseling LLC

  • Addiction (Substance Use Disorder) Counselor
  • Jackson, TN
  • NPI 1386169050
  Medicare reassignment Care Compare group NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  TN

  Medicare reassignment
• Region IV Chemical Dependency Complex

  • Substance Abuse Rehabilitation Facility
  • Corinth, MS
  • NPI 1982980850
  NPD (past)
• Region IV Desoto County Pharmacy

  • Community/Retail Pharmacy
  • Hernando, MS
  • NPI 1689915423
  NPD (past)

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

{
    "created_epoch": "1271894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764806400000",
    "number": "1851618433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 REBEL CV",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383017707",
            "telephone_number": "731-234-2165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 REBEL CV",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383017707",
            "telephone_number": "731-234-2165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JESSE",
        "credential": "LPC/MHSP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-22",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "4913",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MS",
            "license": "0044",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Billy Zachary Johnson, PA-C
• Brylie Johnson, PTA
• Corey Lee Johnson
• Doretha Johnson, LMSW
• Jeffrey Johnson, SLP
• Justice B Johnson, DMD
• Katie Alyse Johnson, FNP
• Keli Johnson, CLINICIAN
• Kristi Rene Johnson, RN
• Krystle Elizabeth Amelia Johnson

• Professional Counselor in Jackson, TN
• Providers in Jackson, TN by specialty
• Professional Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.