Lisa Michele Johnson | Tacoma, WA • PECOS Search

Lisa Michele Johnson

Counselor

Behavioral Health & Social Service Providers

2615 S 14th St, Tacoma, WA 98405-2627

PECOS Enrollment

Based on the most recent information from CMS, provider Lisa Michele Johnson does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 4 days ago.

Profile Details

Provider ID
1225651730
Provider Type
Individual
Full Name
Johnson, Lisa Michele
Credential
LMHCA

Gender
Female
Sole Proprietor
No
Enumeration Date
5/19/2020
Last Updated
5/19/2020

Contact Information

Practice Location

2615 S 14th St, Tacoma, WA 98405-2627

Unlisted Fax

Mailing Location

2615 S 14th St, Tacoma, WA 98405-2627

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YM0800X Primary	Description Counselor Behavioral Health & Social Service Providers	License MC61038293 Washington