Healthcare Provider Details

I. General information

NPI: 1437627882
Provider Name (Legal Business Name): KAMBRA ROCHELLE JOHNSON LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2018
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 453
LYLE WA
98635-0010
US

IV. Provider business mailing address

PO BOX 453
LYLE WA
98635-0010
US

V. Phone/Fax

Practice location:
  • Phone: 509-213-0984
  • Fax:
Mailing address:
  • Phone: 509-213-0984
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: