MEDICARE: RADIANT TRUTH COUNSELING, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1407780794
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RADIANT TRUTH COUNSELING, LLC

Provider Business Mailing Address
First Line	:	5026 N 189TH DR
Second Line	:
City	:	LITCHFIELD PARK
State	:	AZ
Zip	:	85340-5478
Country	:	US
Telephone Number	:	602-615-3450
Fax Number	:

Provider Business Practice Location Address
First Line	:	5476 W FULTON ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85043-4710
Country	:	US
Telephone Number	:	602-615-3450
Fax Number	:

Authorized Official
Title or Position	:	CEO/ THERAPIST
Name	:	JOSHUA JOHNSON
Credential	:	LCSW
Telephone Number	:	602-615-3450

Provider Enumeration Date	:	06/11/2026
Last Update Date	:	06/11/2026

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