Individual
LISA JAYNES JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
3214 PURDUE PL NE, ALBUQUERQUE, NM 87106-2124
(505) 288-2162
Mailing address
817 CARLISLE BLVD NE, ALBUQUERQUE, NM 87106-1209
(505) 288-2162
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1710
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10001443
LOVELACE HEALTH PLAN
NM
01
—
112391
VALUE OPTIONS PPO
NM
01
—
87726
UNITED HEALTH PLAN
NM
01
—
NM02JE00
BLUE CROSS BLUE SHEILD ID
NM
01
—
NM100184
VALUE OPTIONS NM
NM
05
—
Z7949
—
NM
Enumeration date
06/21/2006
Last updated
07/09/2007
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