CANDACE JOHNSON – Counselor, NPI 1073028601

CANDACE JOHNSON is a healthcare provider. based in Fern park, Florida. specializing in MENTAL HEALTH COUNSELOR. The NPI Number for CANDACE JOHNSON is 1073028601

Main info

Female
15 Years Of Experience
Accepts Medicare Assignment
Name
CANDACE JOHNSON
NPI
1073028601
Phone
Not provided
Address
237 FERNWOOD BLVD
Enumeration Date
5 December 2017
Last Update Date
5 December 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4078753700
Graduation Year
2011 (15 years ago)
PAC ID
6406203124
Group Practice PAC ID
8325936446
Professional Enrollment ID
I20231116002878
Address ID
FL328085646OR1800XDRXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience21
Completeness75
Years active:8State licenses:0Digital endpointsOther names

3,018 MENTAL HEALTH COUNSELOR in FL

Provider Addresses for CANDACE JOHNSON

  • 237 FERNWOOD BLVD

    FERN PARK, FL 327302116

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-11-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20231116002878IMental Health CounselorFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32730)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8325936446View full group profile
NameSpecialtyState
Nurse PractitionerFL
Mental Health CounselorFL
Mental Health CounselorFL
-TN
-FL
P S Y C H I A T R YMI
Mental Health CounselorFL
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL

Reviews

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Frequently asked questions

What unique ID ties claims to CANDACE JOHNSON?
NPI 1073028601 is assigned to CANDACE JOHNSON under the national enumeration system.
Is CANDACE JOHNSON's NPI currently valid?
The extract we use shows CANDACE JOHNSON as active.
Can you summarize CANDACE JOHNSON's specialty in plain language?
Clinically, the directory lists CANDACE JOHNSON with Counselor. Clinical services aligned with this taxonomy classification.
What location metadata exists for CANDACE JOHNSON?
The page summarizes Fern Park, Florida for CANDACE JOHNSON; expand the address list for detail.
Is CANDACE JOHNSON a real provider?
This page reflects official NPPES data for NPI 1073028601. Always confirm identity and privileges with the practice and licensing boards.

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