Individual provider Active NPI

Moniesha Johnson

  • Speech-Language Pathologist
  • Pikesville, MD
National Provider Identifier
1023826526
Registry record updated Apr 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
03052L Issued in MD
Practice address
115 Sudbrook LN Ste a
Pikesville, MD 21208-4184
Phone
(410) 358-1997
NPI assigned
Dec 30, 2024
Last updated
Apr 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 03052L MD Primary

Addresses

Primary practice location

115 Sudbrook LN Ste a
Pikesville, MD 21208-4184

Mailing address

646 Hallmark Dr Apt T3
Glen Burnie, MD 21061-4794
Phone (646) 724-4933

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
03052LMDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Speech Therapy LLC Speech-Language Pathologist PastSince Jan 1, 2025 Accepting new patients
Metro Occupational Therapy LLC PastSince Jan 1, 2025 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1735516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744502400000",
    "number": "1023826526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "646 HALLMARK DR APT T3",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210614794",
            "telephone_number": "646-724-4933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 SUDBROOK LN STE A",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212084184",
            "telephone_number": "410-358-1997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MONIESHA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-30",
        "last_updated": "2025-04-13",
        "certification_date": "2025-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "03052L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pikesville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2025; 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.