Marlena Laura-Joann Johnson, QMHP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

094265 Issued in OR

Practice address

444 Villa Rd
Newberg, OR 97132-1856

Phone

(503) 431-0063

Fax

(503) 554-1848

NPI assigned

Sep 17, 2012

Last updated

May 15, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Marlena Laura-Joann Johnson Professional name

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Living Tree Wellness Center, LLC

  • Clinical Social Worker
  • Newberg, OR
  • NPI 1245966613
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1347840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557878400000",
    "number": "1437409414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 BRUTSCHER ST STE D PMB 150",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971326096",
            "telephone_number": "503-431-0063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 VILLA RD",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971321856",
            "telephone_number": "503-431-0063",
            "fax_number": "503-554-1848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARLENA",
        "middle_name": "LAURA-JOANN",
        "name_prefix": "Mrs.",
        "credential": "QMHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-17",
        "last_updated": "2019-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "094265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARLENA",
            "last_name": "JOHNSON",
            "middle_name": "LAURA-JOANN",
            "credential": "QMHP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Candi Johnson, LMT
• Christine Lin Johnson, MD
• David P Johnson, MD
• Joshua Laurence Johnson, MD
• Julie Ann Johnson, RPH
• Thomas Michael Johnson, M.D., PH.D.
• Leon Vernon Jones, DDS
• Jennifer M. Jordan, N.P.
• Linda Josten
• Victoria Grace Juarez

• Clinical Social Worker in Newberg, OR
• Providers in Newberg, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.