Healthcare Provider Details

I. General information

NPI: 1245902188
Provider Name (Legal Business Name): EMILY JOHNSON LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2021
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14218 E 1ST DR APT C5
AURORA CO
80011-8764
US

IV. Provider business mailing address

14218 E 1ST DR APT C5
AURORA CO
80011-8764
US

V. Phone/Fax

Practice location:
  • Phone: 870-844-1220
  • Fax:
Mailing address:
  • Phone: 870-844-1220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0015830
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: