Healthcare Provider Details

I. General information

NPI: 1154853497
Provider Name (Legal Business Name): JOHNNA VERNON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2017
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 W DAVIES AVE N
LITTLETON CO
80120-5252
US

IV. Provider business mailing address

155 INVERNESS DR W SUITE 200
ENGLEWOOD CO
80112-5095
US

V. Phone/Fax

Practice location:
  • Phone: 303-730-8858
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberCMF0221551
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: