Individual provider Active NPI

Mary-Elizabeth Johnson

  • Student in an Organized Health Care Education/Training Program
  • Issaquah, WA
National Provider Identifier
1043840887
Registry record updated Jan 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
414 Front St N
Issaquah, WA 98027-2914
Phone
(425) 392-6367
NPI assigned
Jan 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

414 Front St N
Issaquah, WA 98027-2914

Mailing address

2410 Boyer Ave E Apt 310
Seattle, WA 98112-2145

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

Practice roles

OrganizationSpecialtyStatusNew patients
Friends of Youth Mental Health Past Accepting new patients
Bene Therapy PLLC Mental Health Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1579564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579564800000",
    "number": "1043840887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 BOYER AVE E APT 310",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981122145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 FRONT ST N",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272914",
            "telephone_number": "425-392-6367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARY-ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-21",
        "last_updated": "2020-01-21",
        "certification_date": "2020-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2020; 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.