Detrial Williams Johnson, PMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

PMFT 130 Issued in FL

Practice address

5707 N 22ND St
Tampa, FL 33610-4350

Phone

(813) 239-8506

Fax

(813) 239-8394

NPI assigned

Aug 18, 2010

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

Other names 1

• Deatreal Denise Williams Former name

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": "1282089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442534400000",
    "number": "1184939886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5707 N 22ND ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336104350",
            "telephone_number": "813-239-8506",
            "fax_number": "813-239-8394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5707 N 22ND ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336104350",
            "telephone_number": "813-239-8506",
            "fax_number": "813-239-8394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DETRIAL",
        "middle_name": "WILLIAMS",
        "credential": "PMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-18",
        "last_updated": "2015-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "PMFT 130",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEATREAL",
            "last_name": "WILLIAMS",
            "middle_name": "DENISE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• David Albert Johnson, M.D.
• David J Johnson, D.C.
• Deanna Celes Johnson, LPN
• Denis C. I. Johnson, M.D.
• Detevia Johnson, MS, LAT, ATC
• Diana Harris Johnson, LCSW
• Diana Irene Johnson, DDS
• Eleanor Rose Johnson
• Elizabeth Johnson, PHARMD
• Eric Johnson, DPT

• Marriage & Family Therapist in Tampa, FL
• Providers in Tampa, FL by specialty
• Marriage & Family Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2015; 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.