Individual provider Active NPI

Semikah Yisrael-Johnson, LCMFT

  • Marriage & Family Therapist
  • Largo, MD
National Provider Identifier
1053810176
Registry record updated Feb 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LCM657 Issued in MD
Practice address
1400 Mercantile LN Ste 208
Largo, MD 20774-5350
Phone
(202) 681-5226
NPI assigned
Feb 4, 2018
Last updated
Feb 4, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LCM657 MD Primary

Addresses

Primary practice location

1400 Mercantile LN Ste 208
Largo, MD 20774-5350

Mailing address

12138 Central Ave Ste 145
Bowie, MD 20721-1910
Phone (202) 681-5226

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241022002390 FL Practitioner - Marriage and Family Therapist 4183156706 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCM657MDMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Nassau County Mental Health Alcohol & Drug Abuse Council Inc CurrentSince Oct 1, 2024 Accepting new patients
Committed to the Journey LLC Marriage & Family Therapist Current Accepting new patients

Locations

463142 State Road 200
Yulee, FL 32097
Phone (904) 225-8280

12138 Central Ave
Mitchellville, MD 20721
Phone (240) 603-6527

1400 Mercantile Ln
Ste 208
Upper Marlboro, MD 20774
Phone (202) 681-5226

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": "1517702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517702400000",
    "number": "1053810176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12138 CENTRAL AVE STE 145",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207211910",
            "telephone_number": "202-681-5226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 MERCANTILE LN STE 208",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207745350",
            "telephone_number": "202-681-5226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YISRAEL-JOHNSON",
        "first_name": "SEMIKAH",
        "credential": "LCMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-04",
        "last_updated": "2018-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MD",
            "license": "LCM657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, MD

Sources for this page

Verify at the official NPI Registry.