Persephone Johansson

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MC60736722 Issued in WA

Practice address

615 W Titus St Ste 103
Kent, WA 98032-5749

Phone

(860) 578-6287

NPI assigned

Jan 2, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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": "1514851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514851200000",
    "number": "1306353123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35416 25TH AVE SW APT 7-201",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980233343",
            "telephone_number": "860-578-6287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 W TITUS ST STE 103",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980325749",
            "telephone_number": "860-578-6287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHANSSON",
        "first_name": "PERSEPHONE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-02",
        "last_updated": "2018-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC60736722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacy Jillson
• Charlie N Jim, LMT
• Lee Ann T Jinguji, DDS
• Thomas M Jinguji
• Andrea Johansen
• John Beack DMD PS
• John Cheng
• Kenneth George Johnsen, DDS
• Adam-Omar Johnson
• Andrea Maya Johnson, LM, CPM, MA

• Mental Health Counselor in Kent, WA
• Providers in Kent, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2018; 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.