Provider Demographics
NPI:1053810176
Name:YISRAEL-JOHNSON, SEMIKAH (LCMFT)
Entity type:Individual
Prefix:
First Name:SEMIKAH
Middle Name:
Last Name:YISRAEL-JOHNSON
Suffix:
Gender:F
Credentials:LCMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12138 CENTRAL AVE STE 145
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-1910
Mailing Address - Country:US
Mailing Address - Phone:202-681-5226
Mailing Address - Fax:
Practice Address - Street 1:1400 MERCANTILE LN STE 208
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-5350
Practice Address - Country:US
Practice Address - Phone:202-681-5226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-04
Last Update Date:2018-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCM657106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist