Provider Demographics
NPI:1669953931
Name:JOHNSON, MARIAH DANIELLE (LMHP, LMFT)
Entity type:Individual
Prefix:MRS
First Name:MARIAH
Middle Name:DANIELLE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LMHP, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6401 S 49TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-3284
Mailing Address - Country:US
Mailing Address - Phone:402-730-2191
Mailing Address - Fax:
Practice Address - Street 1:3883 NORMAL BLVD STE 204
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-5218
Practice Address - Country:US
Practice Address - Phone:539-249-2324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-24
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE5800101YM0800X
NE220106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health