Active NPI
Darrick Lee Johns, MA, NA, AAC
- Mental Health Counselor
- Puyallup, WA
National Provider Identifier
1891078291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LH60514070
- Practice address
- 325 E Pioneer
Puyallup, WA 98372-3265 - Phone
- (253) 697-8400
- Fax
- (253) 697-3730
- NPI assigned
- Sep 21, 2011
- Last updated
- Jul 28, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NA00175153 | WA | |
| Mental Health Counselor | 101YM0800X | LH60514070 | WA | Primary |
Addresses
Primary practice location
325 E Pioneer
Puyallup, WA 98372-3265
Mailing address
325 E Pioneer
Puyallup, WA 98372-3265
Phone (253) 697-8400
Other names 1
- Iris Lee Bledsoe
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LH60514070 | WA | MD | Mental Health Counselor |
| NA00175153 | WA | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469664000000",
"number": "1891078291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "325 E PIONEER",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983723265",
"telephone_number": "253-697-8400",
"fax_number": "253-697-3730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "325 E PIONEER",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983723265",
"telephone_number": "253-697-8400",
"fax_number": "253-697-3730"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNS",
"first_name": "DARRICK",
"middle_name": "LEE",
"name_prefix": "Mr.",
"credential": "MA, NA, AAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-09-21",
"last_updated": "2016-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "WA",
"license": "NA00175153",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "LH60514070",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "IRIS",
"last_name": "BLEDSOE",
"middle_name": "LEE",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Puyallup, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.