Tabitha Renee Johnson, PHD, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Practice address

2950 Halcyon LN
Suite #605
Jacksonville, FL 32223-6689

Phone

(904) 302-5340

Fax

(904) 800-1211

NPI assigned

Oct 17, 2009

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Tabitha Renee Staier Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Family Therapy Associates of Jacksonville LLC

  • Community/Behavioral Health Agency
  • Jacksonville, FL
  • NPI 1295075190
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1255737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478563200000",
    "number": "1013243542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 HALCYON LN",
            "address_2": "SUITE #605",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322236689",
            "telephone_number": "904-302-5340",
            "fax_number": "904-800-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 HALCYON LN",
            "address_2": "SUITE #605",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322236689",
            "telephone_number": "904-302-5340",
            "fax_number": "904-800-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TABITHA",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "PHD, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-17",
        "last_updated": "2016-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TABITHA",
            "last_name": "STAIER",
            "middle_name": "RENEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sheryl Johnson, LMHC MCAP MAC
• Sierra Johnson
• Stephen Andrew Johnson, MS
• Stephen Dwayne Johnson
• Sydney Terese Johnson I, N/A
• Tammy M Johnson, RN
• Taron Xavier Johnson
• Taylor Johnson, D.O.
• Tevieca Andrews Johnson, PHARMD
• Tierainie C Johnson, MS, MCAP

• Marriage & Family Therapist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Marriage & Family Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.