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General NPI Number Information
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NPI Number | 1518820703
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Entity Type | Organization
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Legal Business Name | J.R. JOHNSON COUNSELING, LLC
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Dates
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Enumeration Date | 12/04/2025
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 16601 N 40TH ST STE 216
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City | PHOENIX
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State | AZ
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Zip | 85032-3354
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Country | US
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Telephone | 480-299-6564
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Fax |
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Provider Business Mailing Address
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Address Line | 4166 W EVANS DR
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City | PHOENIX
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State | AZ
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Zip | 85053-5326
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Country | US
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Telephone | 480-299-6564
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | JACOB RYNE JOHNSON
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Credential | LPC
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Telephone | 480-299-6564
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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