Provider Demographics
NPI:1477104479
Name:JOHNSON, NATALIA (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:NATALIA
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:NATALIA
Other - Middle Name:
Other - Last Name:DIAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LMFT
Mailing Address - Street 1:1161 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SHOEMAKERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19555-1727
Mailing Address - Country:US
Mailing Address - Phone:704-918-9882
Mailing Address - Fax:
Practice Address - Street 1:1105 BERKSHIRE BLVD STE 110
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1222
Practice Address - Country:US
Practice Address - Phone:610-374-4963
Practice Address - Fax:610-378-5403
Is Sole Proprietor?:No
Enumeration Date:2019-09-23
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF001213106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist