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Individual

ANDREW JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
416 GEORGE ST STE B12, DE PERE, WI 54115-2777
(920) 340-0939
Mailing address
416 GEORGE ST STE B12, DE PERE, WI 54115-2777
(920) 340-0939

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
20162-130
WI
101YP2500X
Professional Counselor
Primary
5526-125
WI

Other

Enumeration date
04/20/2021
Last updated
11/15/2023
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