Provider Demographics
NPI:1194542100
Name:JOHNSON, ROBERT TODD (MA, LMFT)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:TODD
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11100 ASH ST STE 105
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1735
Mailing Address - Country:US
Mailing Address - Phone:913-494-2380
Mailing Address - Fax:
Practice Address - Street 1:11100 ASH ST STE 105
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211-1735
Practice Address - Country:US
Practice Address - Phone:913-494-2380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-21
Last Update Date:2024-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS959106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist