KIMBERLY ANNE JOHNSON LCPC
NPI 1194940486
Counselor - Mental Health in Coeur D Alene, ID

Q: What is Kimberly Johnson's NPI number?

The NPI number for Kimberly Johnson is 1194940486. It was assigned to this individual provider in the NPPES registry on April 13, 2007. The provider is also known as Kimberly Anne Breckenridge/Kreaman Lpc, Ncc.

Q: What is Kimberly Johnson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: When was this NPI record last updated?

The NPPES record for Kimberly Johnson was last updated on March 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.

Active since April 13, 2007PECOS EnrolledAccepts Medicare Assignment

3700 W SELTICE WAY, COEUR D ALENE, ID 83814(208) 620-5255(208) 664-9217 Get Directions Write a Review

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

Record update history: Mar 4, 2025, Sep 17, 2024, Jun 21, 2024 (3 updates tracked since 2024).

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About Kimberly Anne Johnson Lcpc NPPES

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

KIMBERLY ANNE JOHNSON LCPC (NPI 1194940486) is an individual mental health provider in Coeur D Alene, Idaho and active in the NPI registry since April 2007. She is enrolled in Medicare PECOS and is a graduate of Other (2006).

NPPES Registry Identity

NPI1194940486

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameKIMBERLY ANNE JOHNSONCredential: LCPC

Location Address3700 W SELTICE WAYCoeur D Alene, ID 83814-8921

Mailing AddressPo Box 1387Hayden, ID 83835-1387 · (208) 664-8347

Phone(208) 620-5255

Fax(208) 664-9217

Sole ProprietorYes

Medical School CMSOtherGraduated 2006

Enumeration DateApril 13, 2007

Last NPPES UpdateMarch 4, 20253 updates tracked since enumeration

NPPES CertifiedMarch 4, 2025

✔ NPI 1194940486 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

Also ListedCounselor · ProfessionalTaxonomy 101YP2500X · License LCPC-4251 (ID)

3700 W SELTICE WAY, Coeur D Alene, ID 83814

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Other Names 1

Former Name (1)Kimberly Anne Breckenridge/kreaman Lpc, Ncc

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan.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

Kimberly Anne Johnson Lcpc 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 ID648613323

PECOS Enrollment IDI20241007002395

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.

TAYLOR LEDBETTER

Counselor (Professional)