BETHANY ANN JOHNSON (NPI# 1144868357) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144868357 |
| Entity Type | Individual |
| Full Name | BETHANY ANN JOHNSON |
| Practice Address |
631 S 1st St Dekalb IL 60115-4117 |
| Mailing Address |
4982 Hummingbird Trl Loves Park IL 61111-1970 |
| Practice Telephone | 8157568501 |
| Mailing Telephone | 8159854088 |
| Enumeration Date | 2019-12-18 |
| Last Update Date | 2019-12-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 474579189001 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619417235 | Bethany Johnson | Behavioral Analyst | 647 13th Ave E Ste A, West Fargo, ND 58078-3328 | 2017-03-01 |
| 1043692254 | Bethany Johnson | Home Health Aide | 981 Deer Chase Court, Stone Mountain, GA 30088 | 2015-06-24 |
| 1871925990 | Bethany Anne Johnson | Counselor | 3050 S. National Ave, 104, Springfield, MO 65804-4807 | 2013-07-31 |
| 1356621569 | Bethany K Johnson | Midwife | 1210 Clark Springs Dr, Keller, TX 76248-3642 | 2011-08-18 |
| 1295956803 | Bethany Johnson | Occupational Therapy Assistant | 2705 Se G Street, Suite 1, Bentonville, AR 72712 | 2007-05-01 |
| 1376171835 | Bethany Noel Johnson | Counselor | 231 E Main St, Lexington, OH 44904-1353 | 2020-03-31 |
| 1427682020 | Bethany Johnson | Speech-Language Pathologist | 525 W Oakland Ave Ste 205, Johnson City, TN 37604-1673 | 2020-02-24 |
| 1841859287 | Bethany Lynne Johnson | Pediatrics | Children's Hospital Outpatient Center, 14 Medical Park, Ste 400, Columbia, SC 29203 | 2019-06-10 |
| 1861968554 | Bethany Ann Johnson | Case Manager/Care Coordinator | 807 E Washington St Ste 150, Medina, OH 44256-3339 | 2018-10-19 |
| 1053892133 | Bethany Anne Johnson | Case Manager/Care Coordinator | 1560 Capalina Rd, San Marcos, CA 92069-1288 | 2018-08-27 |
| Street Address |
631 S 1ST ST |
| City | DEKALB |
| State | IL |
| Zip Code | 60115-4117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972788925 | Community Support Program/reality House | Clinic/Center | 631 S 1st St, Dekalb, IL 60115-4117 | 2008-01-08 |
| 1164023719 | Amanda Marie Reeves | Counselor | 631 S 1st St, Dekalb, IL 60115-4117 | 2020-11-02 |
| 1184223141 | Kendra Scrutchens | Counselor | 631 S 1st St, Dekalb, IL 60115-4117 | 2020-10-21 |
| 1073137519 | Emily Nicole Taylor | Counselor | 631 S 1st St, Dekalb, IL 60115-4117 | 2020-06-01 |
| 1871117564 | Dawn Magnuson | Counselor | 631 S 1st St, Dekalb, IL 60115-4117 | 2020-05-29 |
| 1376164822 | Jasmine Alexis Sronkoski | Social Worker | 631 S 1st St, Dekalb, IL 60115-4117 | 2020-05-06 |
| 1831738616 | Alissa E Taylor | Counselor | 631 S 1st St, Dekalb, IL 60115-4117 | 2019-12-27 |
| 1912546995 | Melissa Ybarra-robinson | Counselor | 631 S 1st St, Dekalb, IL 60115-4117 | 2019-12-23 |
| 1407401086 | Dominique Marie Smith | Counselor | 631 S 1st St, Dekalb, IL 60115-4117 | 2019-08-09 |
| 1912551052 | Tyler Walt | Counselor | 631 S 1st St, Dekalb, IL 60115-4117 | 2019-07-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598372179 | Megan Erhart | Counselor | 304 N. 6th Street, Dekalb, IL 60115 | 2020-09-28 |
| 1689141616 | Stephanie Klewin | Psychologist | 631 S 1st Street, Dekalb, IL 60115 | 2018-10-29 |
| 1164902219 | Kimberly Ann Hart | Counselor | 290 N. Annie Glidden Drive, Gh 416, Niu, Dekalb, IL 60115 | 2018-08-17 |
| 1497235824 | Cory David Michael Hayden | Specialist/Technologist | 175 Yordon Center (niu Athletic Training), Dekalb, IL 60115 | 2018-08-15 |
| 1154807808 | Michael John Borak | Pharmacist | 975 S Annie Glidden Road, Schnucks Market Inc, Dekalb, IL 60115 | 2018-07-16 |
| 1184125841 | Candace Schroeffel | Student in an Organized Health Care Education/Training Program | 520 Garden Rd, Dekalb, IL 60115 | 2018-02-27 |
| 1033627583 | Hannah M Studebaker | Massage Therapist | 3266 Sycamore Road, Dekalb, IL 60115 | 2018-01-18 |
| 1649700238 | Jennifer Mangino | Behavioral Analyst | 138 Berkshire Dr, Dekalb, IL 60115 | 2017-06-15 |
| 1003346628 | Victoria Tullock | Counselor | 631 South First St., Dekalb, IL 60115 | 2017-06-15 |
| 1194263848 | Brianna Kraft | Specialist/Technologist | 900 Crane Dr, Dekalb, IL 60115 | 2017-02-02 |
| Find all providers in zip 60115 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598372179 | Megan Erhart | Counselor | 304 N. 6th Street, Dekalb, IL 60115 | 2020-09-28 |
| 1164902219 | Kimberly Ann Hart | Counselor | 290 N. Annie Glidden Drive, Gh 416, Niu, Dekalb, IL 60115 | 2018-08-17 |
| 1003346628 | Victoria Tullock | Counselor | 631 South First St., Dekalb, IL 60115 | 2017-06-15 |
| 1689109837 | Monique Shante Shaw | Counselor | 2487 Alpha Ct W, Dekalb, IL 60115-5827 | 2017-04-25 |
| 1972946028 | Michael William Elgersma | Counselor | 1500 E Lincoln Hwy Ste 1, Dekalb, IL 60115-3990 | 2013-04-09 |
| 1326391806 | Thomas Mark Kuchynka | Counselor | 1134 Gifford St, Dekalb, IL 60115-4465 | 2012-10-20 |
| 1538432521 | Mark Daniel Lindsey | Counselor | 1400 W Lincoln Hwy, Dekalb, IL 60115-2831 | 2012-02-22 |
| 1932336674 | Jessica Rojas | Counselor | 221 W Lincoln Hwy, Dekalb, IL 60115-3688 | 2009-06-21 |
| 1114126018 | Karyanna Salentine | Counselor | 431 Russell Rd Apt 1, Dekalb, IL 60115-2290 | 2007-07-12 |
| 1255497491 | Sue E. Ouellette | Counselor | 400 E Hillcrest Dr, Suite 100a, Dekalb, IL 60115-2480 | 2006-12-30 |
| Find all providers in DEKALB | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.