Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jacob Ryne Johnson, COUNSELOR, PROF

Individual provider Professional Counselor · NPI 1184180655

Jacob Ryne Johnson, COUNSELOR, PROF is a Mental Health Counselor in Phoenix, Arizona. Qualified in 2015, 11 years ago. Practices with Phoenix Therapists Hub LLC, a 2-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Arizona.

Years since qualifying
11
Licensed in
AZ
In the registry since
2019
Specialties on file
2
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Practice location Address checks out

16601 N 40th St Ste 216
Phoenix, AZ 85032-3354
Phone: (623) 469-0606
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence LPC-17622 (AZ)
Counselor Taxonomy 101Y00000X · Licence LPC-17622 (AZ)

Record details

NPI number1184180655
Entity typeIndividual (Type 1)
GenderMale
Credentials COUNSELOR , PROF
Sole proprietorYes
NPI enumeratedFebruary 20, 2019
Last updated in NPPESDecember 4, 2025
Certification dateDecember 4, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Phoenix Therapists Hub Llc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Phoenix