KIMBERLY ANNE JOHNSON (LCPC) – Mental Health Counselor, NPI 1194940486

KIMBERLY ANNE JOHNSON (LCPC) is a healthcare provider. based in Coeur d alene, Idaho. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials LCPC. They hold a License No. LCPC-4251 (ID). The NPI Number for KIMBERLY ANNE JOHNSON (LCPC) is 1194940486

Main info

Female
Sole Proprietor
20 Years Of Experience
Accepts Medicare Assignment
Name
KIMBERLY ANNE JOHNSON (LCPC)
NPI
1194940486
Phone
(208) 664-9729
Address
1200 W IRONWOOD DR
Enumeration Date
13 April 2007
Last Update Date
4 March 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2086205255
Graduation Year
2006 (20 years ago)
PAC ID
0648613323
Group Practice PAC ID
2466353354
Professional Enrollment ID
I20241007002395
Address ID
ID838148921CO3700XWAYX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience72
Completeness75
Years active:19State licenses:1Digital endpointsOther names

436 MENTAL HEALTH COUNSELOR in ID

Provider Addresses for KIMBERLY ANNE JOHNSON (LCPC)

  • 1200 W IRONWOOD DR

    SUITE 101

    COEUR D ALENE, ID 838142660

    Phone: (208) 664-9729

    Type: Location

  • 3700 W SELTICE WAY

    COEUR D ALENE, ID 838148921

    Phone: (208) 620-5255

    Fax: (208) 664-9217

    Type: Location

  • 2205 N IRONWOOD PL STE A

    COEUR D ALENE, ID 838142610

    Phone: (208) 664-8347

    Fax: (208) 664-9217

    Type: Location

  • PO BOX 1387

    HAYDEN, ID 838351387

    Phone: (208) 664-8347

    Type: Mailing

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: 2024-10-07

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
I20241007002395IMental Health CounselorIDTBD

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 83814)

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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: 2466353354View full group profile
NameSpecialtyState
Nurse Practitioner, Certified Nurse Midwife (Cnm)WA
Mental Health CounselorID
Clinical Social WorkerID
Physician AssistantID
Physician AssistantID
Clinical Social WorkerID
Nurse PractitionerID
Clinical Social WorkerID
Physician AssistantID
Family PracticeID

Reviews

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Frequently asked questions

What federal number belongs to KIMBERLY ANNE JOHNSON (LCPC)?
The federal identifier for KIMBERLY ANNE JOHNSON (LCPC) is NPI 1194940486.
Is KIMBERLY ANNE JOHNSON (LCPC) currently active in the NPI registry?
CMS-published data lists KIMBERLY ANNE JOHNSON (LCPC) as an active registrant.
What field does KIMBERLY ANNE JOHNSON (LCPC) work in?
You can think of KIMBERLY ANNE JOHNSON (LCPC) as practicing within Mental Health Counselor. Clinical services aligned with this taxonomy classification.
Where is KIMBERLY ANNE JOHNSON (LCPC)'s primary listing?
We display Coeur D Alene, Idaho because that is what the record indicates for KIMBERLY ANNE JOHNSON (LCPC).
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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