Individual
MISS MELISSA MARIE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC, NCC, ATR
Contact information
Practice address
9 VOSE AVENUE, SOUTH ORANGE, NJ 07079
(973) 901-9428
Mailing address
3 VOSE AVE, SOUTH ORANGE, NJ 07079-2019
(973) 901-9428
(973) 901-9427
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
37PC00707200
NJ
101YP2500X
Professional Counselor
Primary
37PC00707200
NJ
106H00000X
Marriage & Family Therapist
37PC00707200
NJ
133N00000X
Nutritionist
—
—
221700000X
Art Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578927851
—
NJ
Enumeration date
09/15/2020
Last updated
07/27/2022
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