Individual provider Active NPI

Areil Johnson

  • Addiction (Substance Use Disorder) Counselor
  • Ashtabula, OH
National Provider Identifier
1871127720
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
162043 Issued in OH
Practice address
3418 Lake Ave
Ashtabula, OH 44004-5763
Phone
(614) 784-3508
NPI assigned
Mar 1, 2020
Last updated
Oct 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 162043 OH Primary
Case Manager/Care Coordinator 171M00000X NU

Addresses

Primary practice location

3418 Lake Ave
Ashtabula, OH 44004-5763

Mailing address

3004 Columbus Ave
Ashtabula, OH 44004-5053
Phone (440) 645-4312

Other practice location 1

2921 Parkside Rd
Columbus, OH 43204-2543
Phone (614) 784-3508

Other identifiers 1

IdentifierTypeStateIssuer
0434457MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL areilmackenzie@2gmail.com

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
162043OHMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Group Home, LLC Past Accepting new patients
Phoenix Group Home, LLC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/pathihc/r4/

Organizations & group practices 2

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": "1583020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1871127720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3004 COLUMBUS AVE",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440045053",
            "telephone_number": "440-645-4312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3418 LAKE AVE",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440045763",
            "telephone_number": "614-784-3508"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2921 Parkside Rd",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432042543",
            "country_code": "US",
            "telephone_number": "614-784-3508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "AREIL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-01",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "162043",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0434457",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "areilmackenzie@2gmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "2921 Parkside Rd",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432042543",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ashtabula, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; 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.