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KELLEY LYNN JOHNSON LCPC-S, LCAC
NPI 1639296759
Counselor - Professional in Great Bend, KS

Active since March 23, 2007PECOS EnrolledAccepts Medicare Assignment
809 S PATTON, PO BOX 1223, GREAT BEND, KS 67530(620) 796-2206(620) 796-2208 Get Directions Write a Review

NPPES record last updated: April 2, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Kelley Lynn Johnson Lcpc-s, Lcac NPPES

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

KELLEY LYNN JOHNSON LCPC-S, LCAC (NPI 1639296759) is an individual professional provider in Great Bend, Kansas, licensed in Kansas (2362) and active in the NPI registry since March 2007. She is enrolled in Medicare PECOS and is a graduate of Other (2000).

NPPES Registry Identity

NPI1639296759
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameKELLEY LYNN JOHNSONCredential: LCPC-S, LCAC
Location Address809 S PATTON, PO BOX 1223Great Bend, KS 67530
Mailing AddressPo Box 1223Great Bend, KS 67530-1223 · (620) 796-2206 · Fax (620) 796-2208
Phone(620) 796-2206
Fax(620) 796-2208
Sole ProprietorNo
Medical School CMSOtherGraduated 2000
Enumeration DateMarch 23, 2007
Last NPPES UpdateApril 2, 2025
NPPES CertifiedApril 2, 2025
✔ NPI 1639296759 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 KS · 2362
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 660 (KS)
809 S PATTON, Great Bend, KS 67530
Open in Google Maps ↗

Other Names 1

Former Name (1)Kelley Ferguson

Other Identifiers 1

Medicaid100098090AKS

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Sunflower Health Plan, Ambetter Health, Ambetter Health of Delaware and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kelley Lynn Johnson Lcpc-s, Lcac 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 ID5395285282
PECOS Enrollment IDI20240905004666
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.

Medicare Billing Reassignment

Medicare enrollment records show Kelley Johnson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Avenues For Change
Same address
Mental Health
809 S PATTON RD
Great Bend, KS 67530
  • Reassigned Medicare billing, Kansas enrollment
  • 13 clinicians in this Medicare group
NPI 1114630076 (620) 796-2206

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Kelley Johnson's NPI number?

The NPI number for Kelley Johnson is 1639296759. It was assigned to this individual provider in the NPPES registry on March 23, 2007. The provider is also known as Kelley Ferguson.

Where is Kelley Johnson located?

Kelley Johnson practices at 809 S Patton PO Box 1223, Great Bend, KS 67530. The listed phone number is (620) 796-2206.

What is Kelley Johnson's specialty?

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

Is Kelley Johnson enrolled in Medicare?

Yes. Kelley 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.

Which organization bills Medicare for Kelley Johnson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kelley Johnson reassigns Medicare benefits to Avenues For Change (Great Bend, KS). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kelley Johnson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kelley Johnson accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Sunflower Health Plan, Ambetter of Oklahoma and Blue Cross and Blue Shield of Kansas City and 3 other insurers list Kelley 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 Kelley Johnson was last updated on April 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.