Shelby Kristafer Johnson, LPC-MHSP, NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

5940 Issued in TN

Practice address

2180 Union Ave
Memphis, TN 38104-4205

Phone

(901) 276-2200

NPI assigned

Jan 26, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Kindred Place, Inc.

  • Community/Behavioral Health Agency
  • Memphis, TN
  • NPI 1619241643
  NPD

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

{
    "created_epoch": "1674691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1942916697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2180 UNION AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381044205",
            "telephone_number": "901-276-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2180 UNION AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381044205",
            "telephone_number": "901-276-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SHELBY",
        "middle_name": "KRISTAFER",
        "name_prefix": "Mr.",
        "credential": "LPC-MHSP, NCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-26",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "5940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard S. Johnson, DO
• Robert Reed Johnson, D.C.
• Ruth Ann Johnson, D.PH.
• Shaneka Johnson
• Shannon E Johnson, BA
• Stacy Alana Johnson, M.D., PH.D.
• Stephanie L Johnson, O.D.
• Stephen Michael Johnson, MD
• Sydney Swims Johnson
• Symphony Johnson, LICSWA

• Mental Health Counselor in Memphis, TN
• Providers in Memphis, TN by specialty
• Mental Health Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 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.