Mary A. Johnson, PH.D., LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C2898 Issued in OR

Practice address

202 SE Dorion Ave
Suite 103
Pendleton, OR 97801-2576

Phone

(541) 276-2471

NPI assigned

May 25, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1337904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337904000000",
    "number": "1154681963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 SE DORION AVE",
            "address_2": "SUITE 103",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978012576",
            "telephone_number": "541-276-2471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 SE DORION AVE",
            "address_2": "SUITE 103",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978012576",
            "telephone_number": "541-276-2471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARY",
        "middle_name": "A.",
        "credential": "PH.D., LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-25",
        "last_updated": "2012-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C2898",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "92271",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dominic C Johnson
• Irene Annette Johnson
• Jeremy Johnson
• Katherine Michelle Johnson
• Lisa Ruth Johnson, NP-C
• Robert D Johnson, D.M.D.
• Robert G Johnson Jr., M.D.
• Tyler Patrick Johnson
• Wyatt Johnson, ABOC
• Charles E Johnston, MD

• Professional Counselor in Pendleton, OR
• Providers in Pendleton, OR by specialty
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2012; 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.