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Individual
MR. SAMUEL LEE JOHNSON III
Active
Individual
MR. SAMUEL LEE JOHNSON III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CAC, CCGC
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
NULL
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1603
LA
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
NULL
101YM0800X
Mental Health Counselor
—
NULL
101YP1600X
Pastoral Counselor
—
NULL
101YP2500X
Professional Counselor
5006
LA
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
NULL
103TC1900X
Counseling Psychologist
—
NULL
171000000X
Military Health Care Provider
—
NULL
171M00000X
Case Manager/Care Coordinator
—
NULL
175T00000X
Peer Specialist
—
NULL
225C00000X
Rehabilitation Counselor
—
NULL
251S00000X
Community/Behavioral Health Agency
—
NULL
343900000X
Non-emergency Medical Transport (VAN)
010494439
LA
Other
Enumeration date
10/12/2015
Last updated
01/12/2021
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