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Deactivated NPI 1316559131 Deactivated / Inactive NPI Female Practitioner

Kerry Rose Johnson

Counselor • Shelton, WA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Kerry Johnson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 21, 2020
NPI Deactivation Date August 06, 2021
Total Practice Duration ~1 Years of Practice (2020 – 2021)

Professional Overview & Biography Verified Profile Summary

Kerry Johnson was a registered Counselor practicing in Shelton, WA. Throughout an active medical career spanning 1 years, Kerry Johnson provided care at the practice location at 307 W COTA ST until profile deactivation on 2021-08-06.

Practice Location & Contact Primary Location

Practice Address

307 W Cota St

Shelton, WA 985842265

Telephone 3602058001
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor in Shelton, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 45.0 Yrs
State Avg: 13.0 Yrs
Regional Practice Density
30 Specialists

Practicing in Shelton, WA (11556 Statewide)

Telehealth Adoption Rate
3.3% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Counselor Primary Specialty

NUCC Taxonomy Code: 101Y00000X

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

39 Associated Practitioners
Jennifer Whetstone , RN

Registered Nurse

NPI 1043074636

Registered Nurse

NPI 1063030310

Licensed Mental Health Counselor

Devin Allen , AAC

Counselor - Mental Health

NPI 1063185783
Damani Thomas

Counselor

NPI 1073143004
Morgan Wood

Counselor - Mental Health

NPI 1083579031
Laciel Porter

Behavior Technician

NPI 1093329898

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated August 06, 2021

Record deactivated on August 06, 2021

NPI Profile Active August 21, 2020

NPI status registered as active in NPPES database

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Updated Practice Location August 21, 2020

Registered at 307 W COTA ST, SHELTON, WA 985842265 (Tel: 3602058001)

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Updated Business Mailing Address August 21, 2020

Registered at 320 E BALLYCASTLE WAY, SHELTON, WA 985848596 (Tel: 3604631953)

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Provider Name / Credentials Updated August 21, 2020

Recorded as KERRY JOHNSON

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Medical Taxonomy / Specialty Registered (Primary Specialty) August 21, 2020

Counselor

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Initial NPI Registration & Enumeration August 21, 2020

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1316559131
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 21, 2020
Last Update: August 21, 2020
Deactivation Date: August 06, 2021

Mailing Address

320 E Ballycastle Way

Shelton, WA 985848596

Phone: 3604631953

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.