| Doctor Name: | THERESE ANN JOHNSON |
| NPI Number: | 1033273404 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMHC |
| License Number: | LH00004816 |
| Business Practice Address: | 2955 80th Ave Se Ste 206 Mercer Island, WA - 980402975 |
| Business Phone Number: | 2062320623 |
| Business Fax Number: | 2062320626 |
| Mailing Address: | 2955 80th Ave Se Ste 206, MERCER ISLAND |
| State: | WA |
| Postal Code: | 980402975 |
| Phone Number: | 2062320623 |
| Fax Number: | 2062320626 |
| NPI Enumeration Date: | 12/20/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | LH00004816 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |