MEDICARE: JAROD JOHNSON LPC, LCDC

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	14751	TX
2	101YP2500X	Professional Counselor	C8035	OR
3	101YP2500X	Professional Counselor	82350	TX

General Provider Information

NPI Number	:	1467025536
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAROD JOHNSON LPC, LCDC

Provider Business Mailing Address
First Line	:	2074 S 6TH ST
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97601-3372
Country	:	US
Telephone Number	:	541-841-8110
Fax Number	:	541-885-5512

Provider Business Practice Location Address
First Line	:	2074 S 6TH ST
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97601-3372
Country	:	US
Telephone Number	:	541-841-8110
Fax Number	:	541-885-5512

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

Provider Enumeration Date	:	07/19/2021
Last Update Date	:	06/15/2026

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