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NPI Code Detail

MEDICARE: MRS. PATRICIA M. JOHNSON LMFT

MEDICARE: MRS. PATRICIA M. JOHNSON LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist35001607AIN
2106H00000XMarriage & Family Therapist0635KY

General Provider Information

NPI Number : 1558577197
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. PATRICIA M. JOHNSON LMFT
Provider Business Mailing Address
First Line : 6921 BARTLETT RD
Second Line :
City : LOUISVILLE
State : KY
Zip : 40218-2792
Country : US
Telephone Number : 502-290-3229
Fax Number :
Provider Business Practice Location Address
First Line : 230 E MAPLE ST
Second Line : STE. 4
City : JEFFERSONVILLE
State : IN
Zip : 47130-3420
Country : US
Telephone Number : 812-282-5352
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2007
Last Update Date : 04/27/2009

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