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General NPI Number Information
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NPI Number | 1649544735
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Entity Type | Individual
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Provider Name | RODNEY JOHNSON CADC, LCPC
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Gender | Male
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Dates
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Enumeration Date | 03/07/2012
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Last Update Date | 08/29/2023
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Provider Practice Location Address
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Address Line | 2780 S JONES BLVD STE 115D
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City | LAS VEGAS
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State | NV
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Zip | 89146-5625
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Country | US
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Telephone | 702-935-0025
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Fax | 702-935-0008
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Provider Business Mailing Address
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Address Line | 5382 HOMERIA ST
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City | LAS VEGAS
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State | NV
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Zip | 89113-1839
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Country | US
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Telephone | 702-956-2009
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 00714-C
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | CI636
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | CP5226-R
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License Number State | NV
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