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Individual
MRS. JOELLE JOHNSON
Active
Individual
MRS. JOELLE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LAC-LAC-LIC-1068
MT
1041C0700X
Clinical Social Worker
Primary
SWP-LCSW-LIC-11613
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LAC-LAC-LIC-1068
STATE LICENSE
MT
01
—
SWP-LCSW-LIC-11613
STATE LICENSE
MT
Enumeration date
03/18/2015
Last updated
03/18/2015
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