Healthcare Provider Details

I. General information

NPI: 1336395706
Provider Name (Legal Business Name): ERICA L JOHNSON PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2008
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E STATE ST
ATHENS OH
45701-1856
US

IV. Provider business mailing address

1125 W WOODRUFF AVE
TOLEDO OH
43606-4853
US

V. Phone/Fax

Practice location:
  • Phone: 614-743-4640
  • Fax:
Mailing address:
  • Phone: 419-309-2659
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN270058
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number61151126
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number256698-30
License Number StateWI
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number61151704
License Number StateWA
# 5
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP026168
License Number StateOH
# 6
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN-CNP026168
License Number StateOH
# 7
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number10456-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: