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Provider Information for 1972533560


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Dr. MELISSA LYNN JOHNSON DBH, MC, LPC


Sex: Female

NPI: 1972533560
Last Updated: 2025-01-29
Certification Date: 2025-01-29

Details

NameValue
NPI1972533560
Enumeration Date2006-07-03
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 839 W CONGRESS ST
TUCSON, AZ 85745-2819
United States

Phone: 520-670-3909 | Fax:520-309-2560
 
Primary Practice Address 839 W CONGRESS ST
TUCSON, AZ 85745-2819
United States

Phone: 520-670-3909 | Fax:520-309-2560
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101YP2500X - Counselor - ProfessionalAZ12647