Provider Demographics
NPI:1538600416
Name:JOHNSON, TANIKA MICHELLE (LPC-MHSP, LMHC, NCC)
Entity type:Individual
Prefix:DR
First Name:TANIKA
Middle Name:MICHELLE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LPC-MHSP, LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6025 STAGE RD STE 42-346
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38134-8374
Mailing Address - Country:US
Mailing Address - Phone:901-443-7353
Mailing Address - Fax:901-531-8342
Practice Address - Street 1:3225 KIRBY WHITTEN RD STE 201-2
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38134-2893
Practice Address - Country:US
Practice Address - Phone:901-443-7353
Practice Address - Fax:901-531-8342
Is Sole Proprietor?:No
Enumeration Date:2017-03-13
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC18794101YP2500X
FLMH16906101YP2500X
GALPC011353101YP2500X
MS2245101YP2500X
TX78774101YP2500X
WALH60920960101YP2500X
TN2679101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional