KIM JOHNSON (NPI# 1508277401) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1508277401 |
Entity Type | Individual |
Full Name | KIM JOHNSON |
Credential | MHR, D.MIN, CSAYC |
Practice Address |
1404 S State Ave Indianapolis IN 46203-2009 |
Practice Telephone | 3177834003 |
Practice Fax Number | 3177804810 |
Mailing Telephone | 3177834003 |
Mailing Fax Number | 3177804810 |
Enumeration Date | 2014-05-13 |
Last Update Date | 2014-05-13 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
Y | 323P00000X | Psychiatric Residential Treatment Facility | Residential Treatment Facilities |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649733361 | Kim Michele Johnson | Counselor | 536 Mark Ave, Vallejo, CA 94589-2029 | 2019-04-09 |
1821595067 | Kim Johnson | Technician | 319 Ingraham St Nw, Washington, DC 20011-6603 | 2018-04-12 |
1912410937 | Kim Johnson | Occupational Therapist | 5009 W 95th St Ste A, Oak Lawn, IL 60453-2401 | 2017-11-13 |
1477088433 | Kim Johnson | Counselor | 1041 Lake Francis Drive, Apopka, FL 32712 | 2017-04-27 |
1508312141 | Kim Johnson | Counselor | 2460 W 26th Ave Denver, Denver, CO 80211 | 2016-09-01 |
1851739205 | Kim Johnson | Registered Nurse | 310 N Colonial Rdg, Moorestown, NJ 08057-1633 | 2013-06-07 |
1831432665 | Kim Graham Johnson | Psychiatry & Neurology | 932 Morreene Rd Rm 224, Durham, NC 27705-4410 | 2013-03-29 |
1225338551 | Kim Renee Johnson | Counselor | 527 Bay Rd Ste 104, Queensbury, NY 12804-1430 | 2010-11-03 |
1609042787 | Kim Y Johnson | Licensed Practical Nurse | 2125 James St, Syracuse, NY 13206-3209 | 2008-05-07 |
1780686626 | Kim Edward Johnson | Anesthesiology | 200 Providence Rd Ste 101, Nash Anesthesia Associates, Charlotte, NC 28207-1437 | 2005-08-11 |
Street Address |
1404 S STATE AVE |
City | INDIANAPOLIS |
State | IN |
Zip Code | 46203-2009 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730494360 | Resource Community Based Services Inc | Residential Treatment Facility, Emotionally Disturbed Children | 1404 S State Ave, Indianapolis, IN 46203-2009 | 2010-08-06 |
1104231844 | Anne Lustig | Social Worker | 1404 S State Ave, Indianapolis, IN 46203-2009 | 2014-06-20 |
1235543596 | Options Treatment Acquisition Corporation | Clinic/Center | 1404 S State Ave, Indianapolis, IN 46203-2009 | 2014-06-16 |
1235540907 | Ericka Lewis | Social Worker | 1404 S State Ave, 1404 S. State Ave, Indianapolis, IN 46203-2009 | 2014-05-15 |
1184035040 | Resource Treatment Center | Residential Treatment Facility, Emotionally Disturbed Children | 1404 S State Ave, Indianapolis, IN 46203-2009 | 2014-05-14 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194362665 | Yvonne Irene Wince | Pharmacist | 608 Twin Aire Dr, Indianapolis, IN 46203 | 2019-12-04 |
1730635681 | Kensie Waller | Registered Nurse | 3834 S. Emerson Ave, Bldg C, Ste 100, Indianapolis, IN 46203 | 2016-08-31 |
1629285820 | 21st Century Charter School At Fountain Square | Local Education Agency (LEA) | 1615 South Barth Ave, Indianapolis, IN 46203 | 2007-05-17 |
1912124918 | Richard Walter James | Chiropractor | 3850 S Emerson, Suite F, Indianapolis, IN 46203 | 2007-04-19 |
1245386655 | Gary Richard Billingsley | Chiropractor | 4940 S Emerson Ave, Indianapolis, IN 46203 | 2007-01-26 |
1952452815 | The Health and Hospital Corporation of Marion County | Skilled Nursing Facility | 2630 S Keystone Ave, Indianapolis, IN 46203 | 2007-01-16 |
1245324755 | Rtc Resource Acq Corp | Residential Treatment Facility, Emotionally Disturbed Children | 1404 South State Avenue, Indianapolis, IN 46203 | 2006-10-02 |
1548776925 | Erin Tofani | Nurse Practitioner | 3834 S Emerson Ave, Building C, Suite 100, Indianapolis, IN 46203 | 2017-12-20 |
1114464575 | Abigail G Boris | Registered Nurse | 3834 S Emerson Ave, Bldg C Ste 100, Indianapolis, IN 46203 | 2017-01-24 |
1285184481 | Kelli Joy Bovenkerk | Nurse Practitioner | 3834 S Emerson Ave, Building C, Suite 100, Indianapolis, IN 46203 | 2016-10-12 |
Find all providers in zip 46203 |
Taxonomy Code | 323P00000X |
Grouping | Residential Treatment Facilities |
Classification | Psychiatric Residential Treatment Facility |
A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient’s surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary |
Notes: Source: Champus Policy manual, Volume II, p. 6010.47M dated 9/12/94. Revision: Definition title revised 7/1/03 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831697598 | Indianapolis Vamc | Psychiatric Residential Treatment Facility | 9045 E 59th St Bldg 402, Indianapolis, IN 46216-1030 | 2018-01-29 |
1518382993 | Patrick Mcneill | Psychiatric Residential Treatment Facility | 614 Farley Dr, Indianapolis, IN 46214-3575 | 2014-02-21 |
1598194516 | Damar Services Inc. | Psychiatric Residential Treatment Facility | 6067 Decatur Blvd, Indianapolis, IN 46241-9606 | 2013-11-12 |
1366747685 | Veronica Bridges | Psychiatric Residential Treatment Facility | 1525 N Ritter Ave, Indianapolis, IN 46219-3026 | 2011-01-18 |
1629373048 | Frederick Vandi | Psychiatric Residential Treatment Facility | 1525 N Ritter Ave, Indianapolis, IN 46219-3026 | 2011-01-15 |
1225140965 | Lutheran Child and Family Services of Indiana/kentucky, Inc. | Psychiatric Residential Treatment Facility | 1525 N Ritter Ave, Indianapolis, IN 46219-3026 | 2006-08-31 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1063561272 | Associates In Clinical Psychology PC | Psychiatric Residential Treatment Facility | 317 West Monroe St, Plymouth, IN 46563 | 2007-01-09 |
1134276884 | Youth Opportunity Center, Inc | Psychiatric Residential Treatment Facility | 3700 W Kilgore Ave, Muncie, IN 47304-4810 | 2007-01-04 |
1982774246 | Gibault, Inc. | Psychiatric Residential Treatment Facility | 6401 S Us Highway 41, Terre Haute, IN 47802-4749 | 2006-11-08 |
1801822440 | Hhc Indiana Inc. | Psychiatric Residential Treatment Facility | 1800 N Oak Dr, Plymouth, IN 46563-3406 | 2006-06-24 |
1275080400 | Shirley Mclean | Psychiatric Residential Treatment Facility | 1100 W 6th Ave, Gary, IN 46402-1711 | 2016-09-06 |
1770970337 | Crossroad Child and Family Services | Psychiatric Residential Treatment Facility | 2525 Lake Ave, Fort Wayne, IN 46805-5407 | 2015-04-22 |
1730487901 | Gibault, Inc. | Psychiatric Residential Treatment Facility | 6401 S Us Highway 41, Terre Haute, IN 47802-4749 | 2011-03-11 |
1295901007 | Wellstone Regional Hospital LLC | Psychiatric Residential Treatment Facility | 2700 Vissing Park Rd, Jeffersonville, IN 47130-5989 | 2008-05-01 |
1104974989 | Madison Center, Inc. | Psychiatric Residential Treatment Facility | 403 E Madison St, South Bend, IN 46617-2322 | 2007-01-08 |
1720163603 | Oaklawn Psychiatric Center, Inc. | Psychiatric Residential Treatment Facility | 330 Lakeview Dr, Goshen, IN 46528-9365 | 2006-10-26 |
Find all providers with the same taxonomy |
City | INDIANAPOLIS |
Zip Code | 46203 |
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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.