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General NPI Number Information
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NPI Number | 1396937009
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Entity Type | Organization
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Legal Business Name | JOHNSON COUNSELING AND CONSULTING
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Dates
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Enumeration Date | 08/16/2007
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Last Update Date | 08/16/2007
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Provider Practice Location Address
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Address Line | 505 KING ST SUITE 227
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City | LA CROSSE
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State | WI
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Zip | 54601-9204
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Country | US
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Telephone | 608-796-2710
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Fax | 608-796-2712
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Provider Business Mailing Address
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Address Line | 505 KING ST SUITE 227
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City | LA CROSSE
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State | WI
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Zip | 54601-9204
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Country | US
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Telephone | 608-796-2710
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Fax | 608-796-2712
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOHN DAVID JOHNSON SR.
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Credential | M.S., L.C.S.W.,
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Telephone | 608-796-2710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 2267
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License Number State | WI
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