Patti Jean Johnson, LPC,NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LCPC6122 Issued in ID

Practice address

251 W Arrowrock LN
Boise, ID 83706-4802

Phone

(208) 366-1607

Fax

(208) 366-1602

NPI assigned

May 23, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Miss Patti Jean Gish Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Flourishing Life Counseling

  dba FLC.LLC

  • Adolescent and Children Mental Health Clinic/Center
  • Meridian, ID
  • NPI 1134878861
  NPD Authorized official

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

{
    "created_epoch": "1369267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647993600000",
    "number": "1982041430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 W USTICK RD STE 120",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836466133",
            "telephone_number": "208-366-1607",
            "fax_number": "208-366-1602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 W ARROWROCK LN",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837064802",
            "telephone_number": "208-366-1607",
            "fax_number": "208-366-1602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "PATTI",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "LPC,NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-23",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ID",
            "license": "LPC-5253",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LCPC6122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATTI",
            "last_name": "GISH",
            "middle_name": "JEAN",
            "prefix": "MISS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Megan Johnson, RDN, LD
• Melissa Lee Johnson, CD(DONA)
• Michael A Johnson
• Mikenna Morgan Johnson, PHARMD
• Patricia Marie Johnson, LPC
• Rhonda L Johnson
• Robby Gordon Johnson, MA
• Ryan Johnson, O.D
• Ryan Johnson
• Ryan Tyler Johnson, DPM

• Mental Health Counselor in Boise, ID
• Providers in Boise, ID by specialty
• Mental Health Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2022; 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.