Provider Demographics
NPI:1023172384
Name:JOHNSON, PATRICIA GRIFFITH (LPC, LMFT, MLAP-R)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:GRIFFITH
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LPC, LMFT, MLAP-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 GOSS ROAD
Mailing Address - Street 2:FOX ARMY HEALTH CENTER (CREDENTIALS)
Mailing Address - City:REDSTONE ARSENAL
Mailing Address - State:AL
Mailing Address - Zip Code:35809-7000
Mailing Address - Country:US
Mailing Address - Phone:256-955-6492
Mailing Address - Fax:256-842-2019
Practice Address - Street 1:4100 GOSS RD
Practice Address - Street 2:FOX ARMY HEALTH CENTER (MCD ASAP)
Practice Address - City:REDSTONE ARSENAL
Practice Address - State:AL
Practice Address - Zip Code:35809-7000
Practice Address - Country:US
Practice Address - Phone:256-955-8888
Practice Address - Fax:256-876-3333
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL15522101YA0400X
AL219101YP2500X
ALLMFT86106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD 000Medicare UPIN