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JACOB RYNE JOHNSON COUNSELOR, PROF
NPI 1184180655
Counselor - Professional in Phoenix, AZ

Active since February 20, 2019PECOS EnrolledAccepts Medicare Assignment
16601 N 40TH ST STE 216, PHOENIX, AZ 85032(623) 469-0606 Get Directions Write a Review

NPPES record last updated: December 4, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 4, 2025, Feb 24, 2025, Feb 20, 2019 (3 updates tracked since 2019).

About Jacob Ryne Johnson Counselor, Prof NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACOB RYNE JOHNSON COUNSELOR, PROF (NPI 1184180655) is an individual professional provider in Phoenix, Arizona, licensed in Arizona (LPC-17622) and active in the NPI registry since February 2019. He is enrolled in Medicare PECOS and is a graduate of Other (2015).

NPPES Registry Identity

NPI1184180655
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameJACOB RYNE JOHNSONCredential: COUNSELOR, PROF
Location Address16601 N 40TH ST STE 216Phoenix, AZ 85032-3354
Mailing Address16601 N 40th St Ste 216Phoenix, AZ 85032-3354 · (623) 469-0606
Phone(623) 469-0606
Sole ProprietorYes
Medical School CMSOtherGraduated 2015
Enumeration DateFebruary 20, 2019
Last NPPES UpdateDecember 4, 20253 updates tracked since enumeration
NPPES CertifiedDecember 4, 2025
✔ NPI 1184180655 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in AZ · LPC-17622
Also ListedCounselorTaxonomy 101Y00000X · License LPC-17622 (AZ)
16601 N 40TH ST STE 216, Phoenix, AZ 85032
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Arizona, Oscar Health Plan, Inc., UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jacob Ryne Johnson Counselor, Prof is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1456796739
PECOS Enrollment IDI20240226003657
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHELLE ELAINE SAINT MC
Counselor (Mental Health)
16601 N 40TH ST STE 216
PHOENIX, AZ 85032
Maricopa County (480) 788-8466
MARLENA BEATRICE STANFORD LMSW
Social Worker
16601 N 40TH ST STE 216
PHOENIX, AZ 85032
Maricopa County (480) 788-8466
ELKA MUSHKA CUBACUB MSW
Social Worker (Clinical)
16601 N 40TH ST STE 216
PHOENIX, AZ 85032
Maricopa County (623) 473-1145
SHAWNTA MCDONALD
Counselor (Professional)
16601 N 40TH ST STE 216
PHOENIX, AZ 85032
Maricopa County (480) 788-8466
MORDECHAI GOTTLIEB LMSW
Social Worker (Clinical)
16601 N 40TH ST STE 216
PHOENIX, AZ 85032
Maricopa County (480) 447-9115
MRS. CARLY REINA MSN, APRN, PMHNP-C
Nurse Practitioner (Psychiatric/Mental Health)
16601 N 40TH ST STE 216
PHOENIX, AZ 85032
Maricopa County (314) 335-9388
HEATHER ANN HARVEY APRN, PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
16601 N 40TH ST STE 216
PHOENIX, AZ 85032
Maricopa County (602) 980-2164
BLUE SKIES PSYCHIATRY, PLLC
Clinic/Center (Mental Health (Including Community Mental Health Center))
16601 N 40TH ST STE 216
PHOENIX, AZ 85032
Maricopa County (314) 335-9388

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacob Johnson's NPI number?

The NPI number for Jacob Johnson is 1184180655. It was assigned to this individual provider in the NPPES registry on February 20, 2019.

Where is Jacob Johnson located?

Jacob Johnson practices at 16601 N 40th St Ste 216, Phoenix, AZ 85032. The listed phone number is (623) 469-0606.

What is Jacob Johnson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Jacob Johnson enrolled in Medicare?

Yes. Jacob Johnson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Jacob Johnson accept?

Health plans from Blue Cross Blue Shield of Arizona, Oscar Health Plan, Inc. and UnitedHealthcare list Jacob Johnson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jacob Johnson was last updated on December 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.