Provider Demographics
NPI:1053450114
Name:JOHANSEN, MARGARET A (MS, MFT)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:A
Last Name:JOHANSEN
Suffix:
Gender:F
Credentials:MS, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11145 S EASTERN AVE STE 130
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-4392
Mailing Address - Country:US
Mailing Address - Phone:702-492-6773
Mailing Address - Fax:702-952-0846
Practice Address - Street 1:11135 S EASTERN AVE
Practice Address - Street 2:SUITE 150
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4386
Practice Address - Country:US
Practice Address - Phone:702-492-6773
Practice Address - Fax:702-436-4688
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVMFT #0794101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health