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Kadeem David Johnson

Counselor β€’ Wallingford, CT

Active NPI 1194286005 Individual Practitioner Male Practitioner
Practice location in NPPES

35 Mark Drive
Wallingford, CT 06492

Call 2032650981 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

35 Mark Drive

Wallingford, CT 06492

Telephone 2032650981
Organization at the Same NPPES Address or Phone
Sv Opco Llc Facility NPI 1023576790

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2019

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Wallingford and Connecticut

2 active clinicians are listed under Counselor with a practice address in Wallingford, CT (1,397 in Connecticut).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2023-07-03
Skilled Nursing Facility Primary Specialty

NUCC Taxonomy Code: 314000000X

(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

Counselor

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.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Connecticut Department of Public Health Verification.
Look Up on State Board Site

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

1 listed
Gina Choiniere

Nurse Practitioner

NPI 1538718861

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

8 Historical Events
πŸ“
Updated Practice Location July 10, 2023

Registered at 35 MARK DRIVE, WALLINGFORD, CT 06492 (Tel: 2032650981)

πŸ“
Updated Business Mailing Address July 10, 2023

Registered at 2 PARK PL APT 18E, HARTFORD, CT 061065016

βœ…
NPI Profile Active March 26, 2019

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) March 26, 2019

Registered at 444 CENTER ST, MANCHESTER, CT 060403926 (Tel: 8606463888)

πŸ“
Business Mailing Address (Initial Record) March 26, 2019

Registered at 995 DAY HILL RD, WINDSOR, CT 060951722 (Tel: 8606973351)

πŸ‘€
Provider Name / Credentials (Initial Record) March 26, 2019

Recorded as KADEEM JOHNSON

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) March 26, 2019

Counselor

🟒
Initial NPI Registration & Enumeration March 26, 2019

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1194286005
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 26, 2019
Last Update: July 10, 2023
Sole Proprietor: Yes

Mailing Address

2 Park Pl Apt 18e

Hartford, CT 061065016

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.