Provider Demographics
NPI:1003198607
Name:JOHNSON, WILLIAM MICHAEL (PHD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:MICHAEL
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92-1118 OLANI ST
Mailing Address - Street 2:#2
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-4223
Mailing Address - Country:US
Mailing Address - Phone:808-265-3138
Mailing Address - Fax:
Practice Address - Street 1:92-1118 OLANI ST
Practice Address - Street 2:#2
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-4223
Practice Address - Country:US
Practice Address - Phone:808-265-3138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor