Provider Demographics
NPI:1588835672
Name:LIMMER, JOHANNA ALVINA (MC LPC)
Entity Type:Individual
Prefix:
First Name:JOHANNA
Middle Name:ALVINA
Last Name:LIMMER
Suffix:
Gender:F
Credentials:MC LPC
Other - Prefix:
Other - First Name:JOHANNA
Other - Middle Name:ALVINA
Other - Last Name:MOWATT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MC LPC
Mailing Address - Street 1:13408 N. 1ST STREET
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022
Mailing Address - Country:US
Mailing Address - Phone:623-687-0510
Mailing Address - Fax:
Practice Address - Street 1:2400 W. DUNLAP AVE.
Practice Address - Street 2:SUITE 300
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021
Practice Address - Country:US
Practice Address - Phone:602-943-2999
Practice Address - Fax:602-943-4284
Is Sole Proprietor?:No
Enumeration Date:2008-03-17
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-132011101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional