Acacia Lynette Johnson, LPC in Russellville, AR - Medicare Mental Health Counselor Provider

Acacia Lynette Johnson, LPC is a medicare enrolled "Counselor - Professional" provider in Russellville, Arkansas. She graduated from healthcare school in 2009 and has 16 years of diverse experience with area of expertise as Mental Health Counselor. She is a member of the group practice Simple Soul Counseling Services, Llc and her current practice location is 104 Lock And Dam Rd, Russellville, Arkansas. You can reach out to her office (for appointments etc.) via phone at (479) 222-0268.

Acacia Lynette Johnson is licensed to practice in Arkansas (license number P1202014) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1912149618.

Contact Information

	Acacia Lynette Johnson, LPC
	104 Lock And Dam Rd, Russellville, AR 72802-9725
	(479) 222-0268
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Acacia Lynette Johnson
Gender	Female
Speciality	Mental Health Counselor
Experience	16 Years
Location	104 Lock And Dam Rd, Russellville, Arkansas
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Acacia Lynette Johnson graduated from medical school in 2009

NPI Data:

NPI Number: 1912149618
Provider Enumeration Date: 03/27/2009
Last Update Date: 10/14/2025

Medicare PECOS Information:

PECOS PAC ID: 8022477041
Enrollment ID: I20240129002042

Medical Identifiers

Medical identifiers for Acacia Lynette Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1912149618	NPI	-	NPPES
1912149618	Medicaid	AR
175189795	Medicaid	AR

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YP2500X	Counselor - Professional	P1202014 (Arkansas)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Simple Soul Counseling Services, Llc	6305205329	6

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Acacia Lynette Johnson allows following entities to bill medicare on her behalf.

Entity Name	Simple Soul Counseling Services, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1164144812 PECOS PAC ID: 6305205329 Enrollment ID: O20231028000160

Entity Name	Capps Wellness Clinic And Associates, Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1124744917 PECOS PAC ID: 9931644994 Enrollment ID: O20240715000853

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Acacia Lynette Johnson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Acacia Lynette Johnson, LPC 104 Lock And Dam Rd, Russellville, AR 72802-9725 Ph: (479) 747-5222	Acacia Lynette Johnson, LPC 104 Lock And Dam Rd, Russellville, AR 72802-9725 Ph: (479) 222-0268

Reviews and Comments

Counselor in Russellville, AR

Megan Roshawn Ford, Counselor Medicare: Not Enrolled in Medicare Practice Location: 110 Skyline Dr, Russellville, AR 72801 Phone: 479-967-5570 Fax: 479-890-5364
Raven Cruz-humberto, Counselor Medicare: May Accept Medicare Assignments Practice Location: 104 Lock And Dam Rd, Russellville, AR 72802 Phone: 479-747-5222
Phillip M Higdon, MS LADAC CCS Counselor Medicare: Not Enrolled in Medicare Practice Location: 110 Skyline Drive, Russellville, AR 72801 Phone: 479-968-1298 Fax: 479-968-6053
Mary Caitlyn Conner, Counselor Medicare: Not Enrolled in Medicare Practice Location: 107 N Boston Pl, Russellville, AR 72801 Phone: 479-219-4100
Mrs. Marilyn Jean Mckown, MHPP Counselor Medicare: Accepting Medicare Assignments Practice Location: 1310 W Main St Ste 100, Russellville, AR 72801 Phone: 479-964-2011
Matthew Waymack, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1610 S Arkansas Ave, Russellville, AR 72801 Phone: 479-967-4673 Fax: 479-967-7140
Theodore Gongola, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3205 W Main St, Russellville, AR 72801 Phone: 479-967-4673 Fax: 479-967-7140

Acacia Lynette Johnson, LPC - Medicare Counselor in Russellville, AR