Individual provider Active NPI

Quayila Monea Johnson, LPC

  • Professional Counselor
  • Baton Rouge, LA
National Provider Identifier
1982079901
Registry record updated Aug 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
5482 Issued in LA
Practice address
411 Colonial Dr
Baton Rouge, LA 70806-6506
Phone
(225) 926-9706
NPI assigned
Dec 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 5482 LA Primary

Addresses

Primary practice location

411 Colonial Dr
Baton Rouge, LA 70806-6506

Mailing address

5832 Hartford Ave
Baton Rouge, LA 70812-2233
Phone (225) 975-2546

Other identifiers 1

IdentifierTypeStateIssuer
600964601MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20240424000228 LA Practitioner - Mental Health Counselor 1557700523 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5482LAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Array of Hope Outreach Center CurrentSince Feb 21, 2024 Accepting new patients

Locations

11940 Bricksome Ave
Ste C
Baton Rouge, LA 70816
Phone (225) 250-5829

Organizations & group practices 1

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": "1449014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470268800000",
    "number": "1982079901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5832 HARTFORD AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708122233",
            "telephone_number": "225-975-2546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 COLONIAL DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708066506",
            "telephone_number": "225-926-9706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "QUAYILA",
        "middle_name": "MONEA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-02",
        "last_updated": "2016-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "LA",
            "license": "5482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "600964601",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.