Individual provider Active NPI

Michelle Johnson

  • Mental Health Counselor
  • University Place, WA
National Provider Identifier
1881850998
Registry record updated Dec 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH60608523 Issued in WA
Practice address
4109 Bridgeport Way W Ste C
University Place, WA 98466-4328
Phone
(253) 507-0668
NPI assigned
Jul 29, 2008
Last updated
Dec 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LH60608523 WA Primary

Addresses

Primary practice location

4109 Bridgeport Way W Ste C
University Place, WA 98466-4328

Mailing address

4109 Bridgeport Way W Ste C
University Place, WA 98466-4328
Phone (253) 507-0668

Other names 1

  • Michelle Johnson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LH60608523WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
A M Counseling CurrentSince Feb 2, 2025 Accepting new patients

Locations

4109 Bridgeport Way W
Ste C
University Place, WA 98466
Phone (253) 507-0668

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1217289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735344000000",
    "number": "1881850998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4109 BRIDGEPORT WAY W STE C",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664328",
            "telephone_number": "253-507-0668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4109 BRIDGEPORT WAY W STE C",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664328",
            "telephone_number": "253-507-0668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-29",
        "last_updated": "2024-12-28",
        "certification_date": "2024-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60608523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "JOHNSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in University Place, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2024; 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.