Active NPI
Stefanie Rosel Johnson, LCPC
- Professional Counselor
- O Fallon, IL
National Provider Identifier
1871821074
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180.006694
- Practice address
- 1214 Paragon Dr
Suite 1a
O Fallon, IL 62269-1757 - Phone
- (618) 975-5057
- NPI assigned
- Nov 27, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 180.006694 | IL | Primary |
Addresses
Primary practice location
1214 Paragon Dr
Suite 1a
O Fallon, IL 62269-1757
Mailing address
1214 Paragon Dr
Suite 1a
O Fallon, IL 62269-1757
Phone (618) 975-5057
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
| License | State | Type | Specialty |
|---|---|---|---|
| 180.006694 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1259280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1259280000000",
"number": "1871821074",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1214 PARAGON DR",
"address_2": "SUITE 1A",
"city": "O FALLON",
"state": "IL",
"postal_code": "622691757",
"telephone_number": "618-975-5057"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1214 PARAGON DR",
"address_2": "SUITE 1A",
"city": "O FALLON",
"state": "IL",
"postal_code": "622691757",
"telephone_number": "618-975-5057"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "STEFANIE",
"middle_name": "ROSEL",
"name_prefix": "Ms.",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-11-27",
"last_updated": "2009-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180.006694",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in O Fallon, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.