Healthcare Provider Details

I. General information

NPI: 1366351371
Provider Name (Legal Business Name): ANNA JOHNSON LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

731 N WEBER ST STE 215
COLORADO SPRINGS CO
80903-1019
US

IV. Provider business mailing address

731 N WEBER ST STE 215
COLORADO SPRINGS CO
80903-1019
US

V. Phone/Fax

Practice location:
  • Phone: 719-301-5458
  • Fax: 719-455-0320
Mailing address:
  • Phone: 719-301-5458
  • Fax: 719-455-0320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPCC.0023230
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: