Provider Demographics
NPI:1003142829
Name:SUNJKIC JOHNSON, MARIJA (MA, LPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:MARIJA
Middle Name:
Last Name:SUNJKIC JOHNSON
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:MS
Other - First Name:MARIJA
Other - Middle Name:
Other - Last Name:SUNJKIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LPC, NCC
Mailing Address - Street 1:PO BOX 679
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MI
Mailing Address - Zip Code:49085-0679
Mailing Address - Country:US
Mailing Address - Phone:269-985-2000
Mailing Address - Fax:269-985-2002
Practice Address - Street 1:903 MAIN ST
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085-1426
Practice Address - Country:US
Practice Address - Phone:269-985-2000
Practice Address - Fax:269-985-2002
Is Sole Proprietor?:No
Enumeration Date:2009-10-29
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401011543101YP2500X, 103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling