Healthcare Provider Details

I. General information

NPI: 1992622054
Provider Name (Legal Business Name): RAQUEL SIMEY JOHNSON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2075 E 97TH DR # 80229
THORNTON CO
80229-2467
US

IV. Provider business mailing address

2075 E 97TH DR
THORNTON CO
80229-2467
US

V. Phone/Fax

Practice location:
  • Phone: 720-325-0601
  • Fax:
Mailing address:
  • Phone: 720-325-0601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCSW.09932895
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: