Active NPI
Mary Linda Johnson
- Mental Health Counselor
- Albuquerque, NM
National Provider Identifier
1053819516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 1330 San Pedro Dr NE Ste 201B
Albuquerque, NM 87110-6749 - Phone
- (575) 707-8150
- Fax
- (505) 212-1446
- NPI assigned
- Jan 30, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
1330 San Pedro Dr NE Ste 201B
Albuquerque, NM 87110-6749
Mailing address
2617 Charleston St NE
Albuquerque, NM 87110-3605
Phone (575) 707-8150
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1517270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517270400000",
"number": "1053819516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2617 CHARLESTON ST NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871103605",
"telephone_number": "575-707-8150",
"fax_number": "505-212-1446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1330 SAN PEDRO DR NE STE 201B",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871106749",
"telephone_number": "575-707-8150",
"fax_number": "505-212-1446"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "MARY",
"middle_name": "LINDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-30",
"last_updated": "2018-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.