Individual provider Active NPI

Marilyn J. Johnson, LPC

  • Professional Counselor
  • Flowood, MS
National Provider Identifier
1932601044
Registry record updated Jul 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2224 Issued in MS
Practice address
132 Riverview Dr Ste B
Flowood, MS 39232-8924
Phone
(601) 981-2707
Fax
(601) 981-2701
NPI assigned
Mar 5, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2224 MS Primary

Addresses

Primary practice location

132 Riverview Dr Ste B
Flowood, MS 39232-8924

Mailing address

132 Riverview Dr Ste B
Flowood, MS 39232-8924
Phone (601) 981-2707

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
2224MSMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mindful Wellness Counseling & Consulting Current Accepting new patients
Resilience Counseling & Recovery Center, LLC CurrentSince Feb 1, 2020 Accepting new patients

Locations

132 Riverview Dr
Ste B
Flowood, MS 39232
Phone (601) 981-2707

232 Market St
Jackson, MS 39232
Phone (588) 498-6767

3670 Lakeland Ln
Ste 30
Jackson, MS 39216

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1520208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593648000000",
    "number": "1932601044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 RIVERVIEW DR STE B",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392328924",
            "telephone_number": "601-981-2707",
            "fax_number": "601-981-2701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 RIVERVIEW DR STE B",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392328924",
            "telephone_number": "601-981-2707",
            "fax_number": "601-981-2701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARILYN",
        "middle_name": "J.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-05",
        "last_updated": "2020-07-02",
        "certification_date": "2020-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MS",
            "license": "2224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flowood, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2020; 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.