Provider Demographics
NPI:1891584017
Name:JOHNSON, MYOCHI
Entity type:Individual
Prefix:
First Name:MYOCHI
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4831 WALDEN LAKE POINTE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30035-4172
Mailing Address - Country:US
Mailing Address - Phone:615-294-4333
Mailing Address - Fax:
Practice Address - Street 1:4298 LYNBURN DR
Practice Address - Street 2:
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-4438
Practice Address - Country:US
Practice Address - Phone:615-294-4333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist