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NPI Code Detail

MEDICARE: ROYNEISHA JOHNSON LMFT

MEDICARE: ROYNEISHA 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
1171M00000XCase Manager/Care Coordinator
2106H00000XMarriage & Family Therapist11161OK

General Provider Information

NPI Number : 1518385426
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROYNEISHA JOHNSON LMFT
Provider Business Mailing Address
First Line : 6501 ARLINGTON EXPY STE B105
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32211-0810
Country : US
Telephone Number : 918-300-3864
Fax Number : 918-219-1872
Provider Business Practice Location Address
First Line : 6501 ARLINGTON EXPY STE B105
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32211-0810
Country : US
Telephone Number : 918-618-8197
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2014
Last Update Date : 12/22/2022

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Directions to “ ROYNEISHA JOHNSON LMFT” Practice Location

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