Provider Demographics
NPI:1275942179
Name:VOSS, JOHANNA (MA, LMHC, LMFT)
Entity Type:Individual
Prefix:
First Name:JOHANNA
Middle Name:
Last Name:VOSS
Suffix:
Gender:F
Credentials:MA, LMHC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1904 W ROYALE DR
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-2264
Mailing Address - Country:US
Mailing Address - Phone:765-284-0043
Mailing Address - Fax:765-284-4112
Practice Address - Street 1:1904 W ROYALE DR
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47304
Practice Address - Country:US
Practice Address - Phone:765-284-0043
Practice Address - Fax:765-284-0043
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-05
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA99391106H00000X
101YP1600X
IN39003312A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral