Marilee Johnson, MRC, LPC
Individual provider Active NPI Professional Counselor · Montpelier, ID
NPI 1114208980 · NPPES record last updated Mar 16, 2021
Key facts
- NPI
- 1114208980
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- LPC-5414 (ID)
- Practice address
- 455 Washington St Ste 2
Montpelier, ID 83254-1600 - Phone
- (208) 847-4464
- Fax
- (208) 847-4251
- NPI assigned
- Sep 7, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC-5414 | ID | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bear Lake County Memorial Hospital | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC-5414 | ID | Yes |
Addresses
Primary practice location
455 Washington St Ste 2
Montpelier, ID 83254-1600
Mailing address
455 Washington St Ste 2
Montpelier, ID 83254-1600
Phone (208) 847-4464
Other practice location 1
822 Washington St
Montpelier, ID 83254-1557
Phone (208) 847-4464
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 805405600 | Medicaid | ID |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | MONTPELIER | Direct |
Other providers in Montpelier, ID
- Casey Humpherys
- Ory Brad Hutchison
- Gregory William Hyde
- Flint Dean Jacobson
- Trevor Dean Jacobson
- Joseph F Decker Professional Corp
- Josh Bowman DC PLLC
- Angela K Kelly
- Bobbi Jae Kelsey
- Jacob L. Lufkin
All providers in Montpelier, ID · Professional Counselor in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 16, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.