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Madison Samantha Johnson

Counselor β€’ Olympia, WA

Active NPI 1609494830 Individual Practitioner Female Practitioner
Practice location in NPPES

711 State Ave Ne
Olympia, WA 985063984

Call 3604814565 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

711 State Ave Ne

Olympia, WA 985063984

Telephone 3604814565
Organization at the Same NPPES Address or Phone
Community Youth Services Facility NPI 1386997138

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

NPI first issued

2020

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 Olympia and Washington

414 active clinicians are listed under Counselor with a practice address in Olympia, WA (11,352 in Washington).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Olympia

0% of these 414 clinicians have the CMS telehealth indicator.

0.5% of these 414 clinicians are listed by CMS as accepting Medicare assignment.

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: 2021-06-01
Counselor Primary Specialty

NUCC Taxonomy Code: 101Y00000X

License # reported to NPPES WA CG61177156

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.

Counselor - Mental Health

NUCC Taxonomy Code: 101YM0800X

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: Washington State Department of Health Provider Lookup.
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.

2 listed
Princewill Fonta , PMHNP

Nurse Practitioner - Psychiatric/Mental Health

NPI 1710612239

Psychiatric-Mental Health Nurse Practitioner

Celia Forno , PMHNP

Nurse Practitioner - Psychiatric/Mental Health

NPI 1437293909

Psychiatric-Mental Health Nurse Practitioner

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 June 01, 2021

Registered at 711 STATE AVE NE, OLYMPIA, WA 985063984 (Tel: 3604814565)

πŸ“
Updated Business Mailing Address June 01, 2021

Registered at 711 STATE AVE NE, OLYMPIA, WA 985063984

βœ…
NPI Profile Active July 14, 2020

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) July 14, 2020

Registered at THE EVERGREEN STATE COLLEGE 2700 EVERGREEN PARKWAY NW, OLYMPIA, WA 985050001 (Tel: 3604814565)

πŸ“
Business Mailing Address (Initial Record) July 14, 2020

Registered at 525 TULLIS ST NE, OLYMPIA, WA 985064239

πŸ‘€
Provider Name / Credentials (Initial Record) July 14, 2020

Recorded as MADISON JOHNSON

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 14, 2020

Counselor

🟒
Initial NPI Registration & Enumeration July 14, 2020

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1609494830
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 14, 2020
Last Update: June 01, 2021
Sole Proprietor: Yes

Mailing Address

711 State Ave Ne

Olympia, WA 985063984

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.