Individual provider Active NPI

Lonnie L Johnson Jr.

  • Pastoral Counselor
  • Jacksonville, FL
National Provider Identifier
1952279457
Registry record updated Oct 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pastoral CounselorTaxonomy code 101YP1600X
License
421231 Issued in FL
Practice address
2219 Bridier St
Jacksonville, FL 32206-3244
Phone
(904) 566-8655
NPI assigned
Oct 27, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pastoral CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP1600X 421231 FL Primary

Addresses

Primary practice location

2219 Bridier St
Jacksonville, FL 32206-3244

Mailing address

2219 Bridier St
Jacksonville, FL 32206-3244
Phone (904) 566-8655

Other names 1

  • Renella Mitchell Professional name

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
421231FLMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1761523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761523200000",
    "number": "1952279457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2219 BRIDIER ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322063244",
            "telephone_number": "904-566-8655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2219 BRIDIER ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322063244",
            "telephone_number": "904-566-8655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LONNIE",
        "middle_name": "L",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-10-27",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Pastoral",
            "state": "FL",
            "license": "421231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RENELLA",
            "last_name": "MITCHELL",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2025; 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.