Individual provider Active NPI

Kristin Michelle Johnson, M.A., IMH 9941

  • Mental Health Counselor
  • Altamonte Springs, FL
National Provider Identifier
1972846731
Registry record updated Mar 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
IMH9941 Issued in FL
Practice address
499 N State Road 434
Altamonte Springs, FL 32714-2142
Phone
(407) 291-8009
Fax
(407) 291-9620
NPI assigned
Mar 30, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2013

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 IMH9941 FL Primary

Addresses

Primary practice location

499 N State Road 434
Altamonte Springs, FL 32714-2142

Mailing address

PO Box 161585
Altamonte Springs, FL 32716-1585
Phone (407) 291-8009

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

LicenseStateTypeSpecialty
IMH9941FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1364601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364601600000",
    "number": "1972846731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 161585",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327161585",
            "telephone_number": "407-291-8009",
            "fax_number": "407-291-9620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "499 N STATE ROAD 434",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327142142",
            "telephone_number": "407-291-8009",
            "fax_number": "407-291-9620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KRISTIN",
        "middle_name": "MICHELLE",
        "credential": "M.A., IMH 9941",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-30",
        "last_updated": "2013-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH9941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altamonte Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2013; 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.