Healthcare Provider Details

I. General information

NPI: 1528261724
Provider Name (Legal Business Name): MARSHA LYNN JOHNSON MT-BC, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 FRANKLIN ST
CHELSEA MA
02150-1216
US

IV. Provider business mailing address

31 FRANKLIN ST
CHELSEA MA
02150-1216
US

V. Phone/Fax

Practice location:
  • Phone: 617-201-3999
  • Fax:
Mailing address:
  • Phone: 617-201-3999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number5050
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: