Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Marisa Johnson

Individual provider Mental Health Counselor · NPI 1023596996

Marisa Johnson is a Mental Health Counselor in Latham, New York. Qualified in 2018, 8 years ago. Practices with Community Care Physicians PLLC, a 364-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
8
Licensed in
NY
In the registry since
2018
Specialties on file
2
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Practice location Address checks out

6 Wellness Way Ste 112
Latham, NY 12110-2156
Phone: (518) 881-1109
Fax: (518) 213-6985
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence P10412 (NY)
Mental Health Counselor Taxonomy 101YM0800X

Record details

NPI number1023596996
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 2, 2018
Last updated in NPPESFebruary 26, 2024
Certification dateFebruary 26, 2024
Mailing address6 Wellness Way Ste 201, Latham, NY 12110-2156

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Community Care Physicians Pllc — 364 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Latham