Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kelley Lynn Johnson, LCPC-S, LCAC

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1639296759

Kelley Lynn Johnson, LCPC-S, LCAC is a Mental Health Counselor in Great Bend, Kansas. Qualified in 2000, 26 years ago. Practices with Avenues for Change, a 3-clinician group and accepts Medicare assignment. Licensed in Kansas.

Years since qualifying
26
Licensed in
KS
In the registry since
2007
Specialties on file
2
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Practice location Address checks out

809 S Patton Po Box 1223
Great Bend, KS 67530
Phone: (620) 796-2206
Fax: (620) 796-2208
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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 2362 (KS)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 660 (KS)

Record details

NPI number1639296759
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCPC-S , LCAC
Sole proprietorNo
NPI enumeratedMarch 23, 2007
Last updated in NPPESApril 2, 2025
Certification dateApril 2, 2025

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2000 (26 years in practice)
Group practice Avenues For Change — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Great Bend