Coleen Elizabeth Johnson, MSW, LICSW, CMHS

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LW61501471 Issued in WA

Practice address

2203 Old Highway 99 S Rd
Mount Vernon, WA 98273-9009

Phone

(360) 542-8810

Fax

(360) 542-8811

NPI assigned

Jul 1, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other names 1

• Coleen Elizabeth Payne Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sea Mar Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Mount Vernon, WA
  • NPI 1407325368
  NPD
• Sea-Mar Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Mount Vernon, WA
  • NPI 1225530520
  NPD (past)

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

{
    "created_epoch": "1625097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1164092003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 WESTPOINT CT",
            "city": "BURLINGTON",
            "state": "WA",
            "postal_code": "982332695",
            "telephone_number": "360-846-7309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2203 OLD HIGHWAY 99 S RD",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982739009",
            "telephone_number": "360-542-8810",
            "fax_number": "360-542-8811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "COLEEN",
        "middle_name": "ELIZABETH",
        "credential": "MSW, LICSW, CMHS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-01",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "SC61166287",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WA",
            "license": "SC61166287",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "SC61166287",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "LW61501471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COLEEN",
            "last_name": "PAYNE",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joel P. Gardner, DMD, PS
• John Jarolimek Jr. DC Inc.
• Roseleta Johns, RN
• Christina Marie Johnson, RN
• Christine Johnson, RDH
• Debbie Ann Johnson, M.ED LMHC
• Denise Dianne Johnson, RPH
• Eric R Johnson, M.S.
• Gary K Johnson, M.D.
• Lori Delight Johnson, DC

• Marriage & Family Therapist in Mount Vernon, WA
• Providers in Mount Vernon, WA by specialty
• Marriage & Family Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.