Provider Demographics
NPI:1932469111
Name:JOHNSON, ASHLEY D (MA, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:D
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 1:112 1ST ST W
Mailing Address - Street 2:
Mailing Address - City:BEMIDJI
Mailing Address - State:MN
Mailing Address - Zip Code:56601-4002
Mailing Address - Country:US
Mailing Address - Phone:218-888-8032
Mailing Address - Fax:218-888-8033
Practice Address - Street 1:112 1ST ST W
Practice Address - Street 2:
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-4002
Practice Address - Country:US
Practice Address - Phone:218-888-8032
Practice Address - Fax:218-888-8033
Is Sole Proprietor?:No
Enumeration Date:2012-05-22
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist