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Individual
DR. BENTON KURT JOHNSON II
Active
Individual
DR. BENTON KURT JOHNSON II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, LCPC, LMHC, NCC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
180006524
IL
101YM0800X
Mental Health Counselor
001063
IA
101YM0800X
Mental Health Counselor
Primary
180-006524
IL
101YP2500X
Professional Counselor
180006524
IL
222Q00000X
Developmental Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
208164344
EI PROVIDER #
IL
Enumeration date
04/18/2007
Last updated
07/25/2021
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