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MRS. KRISTEN ANN JOHANSON LCMHC
NPI 1417241936
Counselor - Mental Health in South Burlington, VT

Active since June 01, 2011Opted out of Medicare · through Apr 18, 2028
364 DORSET ST STE 212, SOUTH BURLINGTON, VT 05403(802) 658-9440 Get Directions Write a Review

NPPES record last updated: June 1, 2011. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Mrs. Kristen Ann Johanson Lcmhc NPPES

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

MRS. KRISTEN ANN JOHANSON LCMHC (NPI 1417241936) is an individual mental health provider in South Burlington, Vermont, licensed in Vermont (0680000713) and active in the NPI registry since June 2011. She has opted out of Medicare through April 18, 2028.

NPPES Registry Identity

NPI1417241936
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameMRS. KRISTEN ANN JOHANSONCredential: LCMHC
Location Address364 DORSET ST STE 212South Burlington, VT 05403-6272
Mailing Address70b N Prospect StBurlington, VT 05401-3300 · (802) 324-8318
Phone(802) 658-9440
Sole ProprietorYes
Enumeration DateJune 1, 2011
✔ NPI 1417241936 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in VT · 0680000713
364 DORSET ST STE 212, South Burlington, VT 05403
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Mrs. Kristen Ann Johanson Lcmhc has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 18, 2024 through April 18, 2028.

Opt-Out Effective DateApril 18, 2024
Opt-Out In Effect ThroughApril 18, 2028Opt-out affidavits renew automatically every two years unless cancelled

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 Kristen Johanson's NPI number?

The NPI number for Kristen Johanson is 1417241936. It was assigned to this individual provider in the NPPES registry on June 1, 2011.

Where is Kristen Johanson located?

Kristen Johanson practices at 364 Dorset St Ste 212, South Burlington, VT 05403. The listed phone number is (802) 658-9440.

What is Kristen Johanson's specialty?

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

Is Kristen Johanson enrolled in Medicare?

No. Kristen Johanson has opted out of Medicare through April 18, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Kristen Johanson was last updated on June 1, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years 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.