Emily Ann Johnson, QMHP-R

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

23-QMHP-R-2002 Issued in OR

Practice address

620 NE 2ND St
Gresham, OR 97030-7514

Phone

(971) 274-3757

Fax

(503) 912-5740

NPI assigned

Feb 16, 2021

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 identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1613433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1104419621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1776 SW MADISON ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972051715",
            "telephone_number": "503-224-1044",
            "fax_number": "503-621-2235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 NE 2ND ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970307514",
            "telephone_number": "971-274-3757",
            "fax_number": "503-912-5740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "EMILY",
        "middle_name": "ANN",
        "credential": "QMHP-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-16",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "23-QMHP-R-2002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500815250",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "REST",
            "endpointTypeDescription": "RESTful URL",
            "endpoint": "availity.com",
            "affiliation": "N",
            "address_1": "4371 W Castlebury Ln",
            "city": "Fayetteville",
            "state": "AR",
            "country_code": "US",
            "postal_code": "727046607",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michelle L John, M.D.
• Johnson Chiropractic Clinic PC
• Clotilde Amelia Johnson-Beale, M.D., M.P.H.
• Dawn Marie Johnson, PHARM D
• Debra F Johnson, FNP
• Erica Johnson, DPT
• Gary A. Johnson, D.C.
• Gordon Johnson, MD
• Izabella Johnson, QMHA-SOCIAL WORK
• Jack Eugene Johnson Sr., CADC II/QMHP-C, CSWA

• Mental Health Counselor in Gresham, OR
• Providers in Gresham, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; 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.