KIM JOHNSON


Address: 1404 S State Ave, Indianapolis, IN 46203-2009
Phone: 3177834003

KIM JOHNSON (NPI# 1508277401) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

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

Taxonomy

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

Other Providers KIM JOHNSON

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

Office Location

Street Address 1404 S STATE AVE
City INDIANAPOLIS
State IN
Zip Code 46203-2009

Providers in the same location

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

Providers in the same zip code

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 Information

Taxonomy Code 323P00000X
Grouping Residential Treatment Facilities
Classification Psychiatric Residential Treatment Facility

Taxonomy Definition

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

Providers in the same taxonomy and city

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

Providers in the same taxonomy and state

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

Competitor

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City INDIANAPOLIS
Zip Code 46203

Improve Information

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Dataset Information

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.

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