Provider Demographics
NPI:1649601949
Name:ISAACS, JOHANNA (PSYD)
Entity type:Individual
Prefix:
First Name:JOHANNA
Middle Name:
Last Name:ISAACS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8367 DOVER CT
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80005
Mailing Address - Country:US
Mailing Address - Phone:413-203-9693
Mailing Address - Fax:617-807-0958
Practice Address - Street 1:8367 DOVER CT
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80005
Practice Address - Country:US
Practice Address - Phone:413-203-9693
Practice Address - Fax:617-807-0958
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-12
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS017054103T00000X
PAPS107054103T00000X
CO5555103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist