Provider Demographics
NPI:1386767218
Name:YOHANAS, ISAAC JOSEPH (MA)
Entity type:Individual
Prefix:MR
First Name:ISAAC
Middle Name:JOSEPH
Last Name:YOHANAS
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10806 REISTERSTOWN RD
Mailing Address - Street 2:SUITE 3C
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-2700
Mailing Address - Country:US
Mailing Address - Phone:410-356-9466
Mailing Address - Fax:410-363-2189
Practice Address - Street 1:10806 REISTERSTOWN RD
Practice Address - Street 2:SUITE 3C
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-2700
Practice Address - Country:US
Practice Address - Phone:410-356-9466
Practice Address - Fax:410-363-2189
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCA029101YA0400X
MDLC0392101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional