Provider Demographics
NPI:1235298092
Name:JOHNSON, BARBARA (MA LMFT)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MA LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 40171
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98015-4171
Mailing Address - Country:US
Mailing Address - Phone:425-451-3674
Mailing Address - Fax:
Practice Address - Street 1:11814 SE 5TH ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-3511
Practice Address - Country:US
Practice Address - Phone:425-451-3674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00000986106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist