Individual provider Active NPI

Suzanne Elise Johnson, LPC

  • Mental Health Counselor
  • Oklahoma City, OK
National Provider Identifier
1972626166
Registry record updated Sep 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
3486 Issued in OK
Practice address
4913 W. Reno
Oklahoma City, OK 72127-2212
Phone
(405) 948-4900
Fax
(405) 948-0670
NPI assigned
Apr 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 3486 OK Primary

Addresses

Primary practice location

4913 W. Reno
Oklahoma City, OK 72127-2212

Mailing address

4913 W Reno Ave
Oklahoma City, OK 73127-6339
Phone (405) 948-4900

Other identifiers 1

IdentifierTypeStateIssuer
NAMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240105000365 OK Practitioner - Mental Health Counselor 1658722525 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3486OKMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma Mental Health Council CurrentSince Jan 1, 2024 Accepting new patients
Oklahoma Mental Health Council CurrentSince Jan 1, 2024 Accepting new patients

Locations

4400 N Lincoln Blvd
Oklahoma City, OK 73105

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315872000000",
    "number": "1972626166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4913 W RENO AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731276339",
            "telephone_number": "405-948-4900",
            "fax_number": "405-948-0670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4913 W. RENO",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "721272212",
            "telephone_number": "405-948-4900",
            "fax_number": "405-948-0670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SUZANNE",
        "middle_name": "ELISE",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2011-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "3486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NA",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.