1023172384 NPI number — MRS. PATRICIA GRIFFITH JOHNSON LPC, LMFT, MLAP-R

Table of content: MRS. PATRICIA GRIFFITH JOHNSON LPC, LMFT, MLAP-R (NPI 1023172384)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023172384 NPI number — MRS. PATRICIA GRIFFITH JOHNSON LPC, LMFT, MLAP-R

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JOHNSON
Provider First Name:
PATRICIA
Provider Middle Name:
GRIFFITH
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LPC, LMFT, MLAP-R
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1023172384
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4100 GOSS ROAD
Provider Second Line Business Mailing Address:
FOX ARMY HEALTH CENTER (CREDENTIALS)
Provider Business Mailing Address City Name:
REDSTONE ARSENAL
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35809-7000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
256-955-6492
Provider Business Mailing Address Fax Number:
256-842-2019

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4100 GOSS RD
Provider Second Line Business Practice Location Address:
FOX ARMY HEALTH CENTER (MCD ASAP)
Provider Business Practice Location Address City Name:
REDSTONE ARSENAL
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35809-7000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-955-8888
Provider Business Practice Location Address Fax Number:
256-876-3333
Provider Enumeration Date:
12/21/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YA0400X , with the licence number:  15522 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 101YP2500X , with the licence number: 219 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 106H00000X , with the licence number: LMFT86 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)