MEDICARE: CASEY JOHNS LPCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	307594	KY

General Provider Information

NPI Number	:	1336078195
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASEY JOHNS LPCC

Provider Business Mailing Address
First Line	:	1501 SHELEY WOODS RD
Second Line	:
City	:	NICHOLASVILLE
State	:	KY
Zip	:	40356-8304
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	104 S 2ND ST
Second Line	:
City	:	NICHOLASVILLE
State	:	KY
Zip	:	40356-1553
Country	:	US
Telephone Number	:	859-241-5140
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2026
Last Update Date	:	05/18/2026

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Directions to “ CASEY JOHNS LPCC” Practice Location

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