Elybia Wilson Johnson

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0430 Issued in MS

Practice address

1991 Lakeland Drive
Suite E
Jackson, MS 39216

Phone

(601) 613-6417

Fax

(601) 981-0910

NPI assigned

Oct 2, 2006

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

Other names 1

• Ms. Libby Johnson Other 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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851484414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1991 LAKELAND DRIVE",
            "address_2": "SUITE E",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39216",
            "telephone_number": "601-613-6417",
            "fax_number": "601-981-0910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1991 LAKELAND DRIVE",
            "address_2": "SUITE E",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39216",
            "telephone_number": "601-613-6417",
            "fax_number": "601-981-0910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ELYBIA",
        "middle_name": "WILSON",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MS",
            "license": "0430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LIBBY",
            "last_name": "JOHNSON",
            "prefix": "MS.",
            "credential": "MCP, LPC, LMFT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Christopher Johnson, RRT
• Cyntoria Johnson
• Dannette Smith Johnson, D.O.
• Detrick Johnson
• Elmina Johnson
• Hardin Douglas Johnson, MD
• Hollye R Johnson, MD
• Jana Wilkerson Johnson, OT
• Jennifer Johnson, FNP-C
• Jennifer Johnson, LCSW

• Mental Health Counselor in Jackson, MS
• Providers in Jackson, MS by specialty
• Mental Health Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.