Mikilah Terae Johnson, MA

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

T1770 Issued in OR

Practice address

831 NW Council Dr Ste 300
Gresham, OR 97030-3725

Phone

(503) 258-4600

NPI assigned

Aug 21, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Morrison Child and Family Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Portland, OR
  • NPI 1346382975
  NPD (past)

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

{
    "created_epoch": "1440115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633478400000",
    "number": "1760859052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11035 NE SANDY BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972202553",
            "telephone_number": "503-258-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "831 NW COUNCIL DR STE 300",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303725",
            "telephone_number": "503-258-4600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "303 Van Buren Ave",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946104340",
            "country_code": "US",
            "telephone_number": "503-449-0901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MIKILAH",
        "middle_name": "TERAE",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-21",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OR",
            "license": "T1770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacquelyn L Johnson, CADC II/QMHA-II
• Julie A Johnson, LMHCA
• Kelly Ann Marie Johnson, MOT, OTR/L
• Loretta Eileen Johnson
• Lorita Elaine Johnson, LMT
• Penny Johnsrud, FNP
• Emmaline Johnston
• Kari Johnston, D.C.
• McKenzie Johnston, PCA
• Maria G Jolley, R.D.H.

• Marriage & Family Therapist in Gresham, OR
• Providers in Gresham, 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 Oct 6, 2021; 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.