Active NPI
Deserae Johnston, LMHC
- Counselor
- Anthony, NM
National Provider Identifier
1376922690
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- T-0173791
- Practice address
- 254 Merida Dr
Anthony, NM 88021-8225 - Phone
- (575) 649-9327
- NPI assigned
- May 19, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | T-0173791 | NM | Primary |
Addresses
Primary practice location
254 Merida Dr
Anthony, NM 88021-8225
Mailing address
254 Merida Dr
Anthony, NM 88021-8225
Phone (575) 649-9327
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T-0173791 | NM | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1431993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1431993600000",
"number": "1376922690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "254 MERIDA DR",
"city": "ANTHONY",
"state": "NM",
"postal_code": "880218225",
"telephone_number": "575-649-9327"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "254 MERIDA DR",
"city": "ANTHONY",
"state": "NM",
"postal_code": "880218225",
"telephone_number": "575-649-9327"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSTON",
"first_name": "DESERAE",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-05-19",
"last_updated": "2015-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NM",
"license": "T-0173791",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anthony, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.