MEDICARE: MS. ANN P. JOHNSON MED,LAC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	40	CO
2	101YM0800X	Mental Health Counselor	0	CO

General Provider Information

NPI Number	:	1043492747
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANN P. JOHNSON MED,LAC

Provider Business Mailing Address
First Line	:	777 S WADSWORTH BLVD
Second Line	:	BLDG. 2, SUITE 205
City	:	LAKEWOOD
State	:	CO
Zip	:	80226-4300
Country	:	US
Telephone Number	:	303-989-9577
Fax Number	:	303-989-9890

Provider Business Practice Location Address
First Line	:	777 S WADSWORTH BLVD
Second Line	:	BLDG. 2, SUITE 205
City	:	LAKEWOOD
State	:	CO
Zip	:	80226-4300
Country	:	US
Telephone Number	:	303-989-9577
Fax Number	:	303-989-9890

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/04/2007
Last Update Date	:	06/14/2026

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