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NPI Code Detail

MEDICARE: KRISTA JOHNSON MA, LPC, NCC

MEDICARE: KRISTA JOHNSON MA, LPC, NCC
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
1101YP2500XProfessional Counselor4401CO

General Provider Information

NPI Number : 1912039652
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTA JOHNSON MA, LPC, NCC
Provider Business Mailing Address
First Line : 2021 W COLORADO AVE
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80904-3840
Country : US
Telephone Number : 719-632-2663
Fax Number : 719-213-2552
Provider Business Practice Location Address
First Line : 2021 W COLORADO AVE
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80904-3840
Country : US
Telephone Number : 719-632-2663
Fax Number : 719-213-2552
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2007
Last Update Date : 07/08/2007

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