Healthcare Provider Details

I. General information

NPI: 1295654325
Provider Name (Legal Business Name): EMILY MARIE JOHNSON MS, PLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 STARR AVE
STARKVILLE MS
39759-4032
US

IV. Provider business mailing address

193 OLD MAYHEW RD APT 91
STARKVILLE MS
39759-9254
US

V. Phone/Fax

Practice location:
  • Phone: 662-340-5947
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberP-1446
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: