Amy S Johannes, CSAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

2137 Issued in WI

Practice address

1044 S Park Ave
Fond Du Lac, WI 54935-8031

Phone

(920) 539-9427

NPI assigned

Aug 8, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Affect Therapeutics Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Charlottesville, VA
  • NPI 1104402064

  Addiction (Substance Use Disorder)

  NPD (past)
• Affect Therapeutics, Inc.

  • Adult Mental Health Clinic/Center
  • Athens, OH
  • NPI 1528878832
  NPD (past)

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1912917352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1044 S PARK AVE",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549358031",
            "telephone_number": "920-539-9427",
            "fax_number": "920-926-8885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 S PARK AVE",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549358031",
            "telephone_number": "920-539-9427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHANNES",
        "first_name": "AMY",
        "middle_name": "S",
        "credential": "CSAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WI",
            "license": "2137",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "38635",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "162616",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "4127",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "2137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brooke Laine Jeske, APNP
• Kevin Andrew Jessen, M.D.
• Fangda Jiang, MD
• Patricia Ann Jirovetz, MS-ATRL
• Sachin S Jogal, MD
• Johnson Chiropractic Health Center, SC
• Johnson Chiropractic Health Service
• Aaron R Johnson, M.D.
• Bret Zachary Johnson, D.C.
• Julie A Johnson, NP

• Addiction (Substance Use Disorder) Counselor in Fond Du Lac, WI
• Providers in Fond Du Lac, WI by specialty
• Addiction (Substance Use Disorder) Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2023; 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.