Melissa Ruby Johnson, MA, LLPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401019354 Issued in MI

Practice address

3298 Veterans Dr
Traverse City, MI 49684-4725

Phone

(231) 715-8466

Fax

(231) 943-2263

NPI assigned

May 14, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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

Locations

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.

• Adaptive Counseling and Case Management, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Traverse City, MI
  • NPI 1588906119

  Professional

  NPD

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

{
    "created_epoch": "1620950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620950400000",
    "number": "1770157729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3298 VETERANS DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496844725",
            "telephone_number": "231-715-8466",
            "fax_number": "231-943-2263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3298 VETERANS DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496844725",
            "telephone_number": "231-715-8466",
            "fax_number": "231-943-2263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MELISSA",
        "middle_name": "RUBY",
        "credential": "MA, LLPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-14",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401019354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jesse Clark Johnson, M.D.
• Julie K Johnson, D.O.
• Karl Frederick Johnson II, RPH
• Laura Johnson, MS, GC
• Melissa Jean Johnson
• Ursula Johnson, LMSW
• Karen Johnston Jackson
• Alexandra Ann Johnston
• Chad Johnston
• Barbara Jones Smith, PHD

• Professional Counselor in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.