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General NPI Number Information
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NPI Number | 1255946216
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Entity Type | Individual
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Provider Name | MELISSA MARIE JOHNSON MA, LPC, NCC, ATR
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Gender | Female
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Dates
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Enumeration Date | 09/15/2020
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Last Update Date | 07/27/2022
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Provider Practice Location Address
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Address Line | 9 VOSE AVENUE
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City | SOUTH ORANGE
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State | NJ
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Zip | 07079
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Country | US
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Telephone | 973-901-9428
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Fax |
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Provider Business Mailing Address
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Address Line | 3 VOSE AVE
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City | SOUTH ORANGE
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State | NJ
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Zip | 07079-2019
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Country | US
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Telephone | 973-901-9428
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Fax | 973-901-9427
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 37PC00707200
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 37PC00707200
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 221700000X
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Taxonomy Name | Art Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 37PC00707200
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License Number State | NJ
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