Ellen Claire Johnson, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

IMF 71389 Issued in CA

Practice address

1181 SW Ramsey Ave
Grants Pass, OR 97527-5835

Phone

(541) 476-2373

NPI assigned

Sep 29, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Ellen Claire Vandenberg 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": "1285718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559001600000",
    "number": "1629387238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 SW G ST",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975262544",
            "telephone_number": "541-476-2373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1181 SW RAMSEY AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275835",
            "telephone_number": "541-476-2373"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7200 Skyway",
            "address_purpose": "LOCATION",
            "city": "Paradise",
            "state": "CA",
            "postal_code": "959693280",
            "country_code": "US",
            "telephone_number": "530-877-1965",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ELLEN",
        "middle_name": "CLAIRE",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-29",
        "last_updated": "2019-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF 71389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLEN",
            "last_name": "VANDENBERG",
            "middle_name": "CLAIRE",
            "credential": "LMFT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jessica Alyse Johnsen
• Joshua David Johnsen, M.A.
• Kassie Johnsgard, CPSS
• Amanda C Johnson
• Amy Johnson
• Howard Finlayson Johnson
• Ike Johnson
• Jamey L Johnson, CRNA
• Kathleen Anne Johnson, F.N.P.
• Kimberly Ann Johnson, PHYSICAL THERAPIST

• Marriage & Family Therapist in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• Marriage & Family Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2019; 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.