Mary Elizabeth Serey Johnson, LC-PC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LC2304 Issued in MD

Practice address

81 W Frederick St
Walkersville, MD 21793-8216

Phone

(240) 236-7200

NPI assigned

Dec 6, 2018

Last updated

Dec 6, 2018By 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 identifiers 1

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": "1544054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544054400000",
    "number": "1598236226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 S EAST ST",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217015918",
            "telephone_number": "240-236-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 W FREDERICK ST",
            "city": "WALKERSVILLE",
            "state": "MD",
            "postal_code": "217938216",
            "telephone_number": "240-236-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARY",
        "middle_name": "ELIZABETH SEREY",
        "credential": "LC-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-06",
        "last_updated": "2018-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC2304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED CLINICAL PROFESSIONAL COUNSELOR",
            "identifier": "LC2304",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Walkersville, MD
• Providers in Walkersville, MD by specialty
• Professional Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.