Michael William Johndro, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

86 Issued in AK

Practice address

634 S Bailey St
Suite 207
Palmer, AK 99645-6330

Phone

(907) 745-7080

Fax

(907) 745-6263

NPI assigned

Jan 4, 2007

Last updated

Sep 6, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Borealis Behavioral Health

  • Marriage & Family Therapist
  • Palmer, AK
  • NPI 1508121096
  NPD (past)
• Holladay & Associates, LLC

  dba Holladay & Associates

  • Psychiatry Physician
  • Palmer, AK
  • NPI 1538284138

  Marriage & Family Therapist

  NPD (past)

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346889600000",
    "number": "1891842472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "634 S BAILEY ST",
            "address_2": "SUITE 207",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996456330",
            "telephone_number": "907-745-7080",
            "fax_number": "907-745-6263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "634 S BAILEY ST",
            "address_2": "SUITE 207",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996456330",
            "telephone_number": "907-745-7080",
            "fax_number": "907-745-6263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNDRO",
        "first_name": "MICHAEL",
        "middle_name": "WILLIAM",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2012-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "AK",
            "license": "86",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERICAL INSURANCE",
            "identifier": "45-5503677",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE GROUP GROUP BILLING",
            "identifier": "421545189",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2383280",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "561028000",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "561028000",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MH9931",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rick R Jahn Jr., D.O.M.
• Samantha Jamison
• Jesse Atwood MD Pediatrics, LLC (Jesse Atwood MD Pediatrics)
• Russell A Johanson, M.D.
• Erin Michelle John
• Hannah Christine Johnson
• Jaclyn H Johnson
• Jacquelyn Johnson, OTD/R/L
• La' Zayvia SM Johnson
• Lynsey Johnson

• Marriage & Family Therapist in Palmer, AK
• Providers in Palmer, AK by specialty
• Marriage & Family Therapist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2012; 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.