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JUDE EDWIN JOHNSON LMFT NPI 1700916012


NPI Information

NPI: 1700916012
Provider Name: JUDE EDWIN JOHNSON, LMFT
Classification: Marriage & Family Therapist - 106H00000X
Entity Type: Individual
Address:
5700 EXECUTIVE CENTER DR STE 110
CHARLOTTE, NC
ZIP 28212
Phone: (704) 525-3255
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Jude Edwin Johnson, LMFT is a marriage family therapist in Charlotte, NC. The provider is a marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. Jude Edwin Johnson, LMFT NPI is 1700916012. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

5700 EXECUTIVE CENTER DR STE 110
CHARLOTTE, NC
ZIP 28212-833
Phone: (704) 525-3255
Fax: (704) 525-0949

The enumeration date for this NPI number is 3/6/2007 and was last updated on 12/20/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1106H00000XMarriage & Family Therapist1166NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11166OTHERNORTH CAROLINALMFT
26105168MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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