Individual
COURTNEY J JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW, CAADC
Contact information
Practice address
6701 OLD 28TH ST SE, STE A, GRAND RAPIDS, MI 49546-6937
(616) 426-2168
(866) 257-5918
Mailing address
1619 GILCREST AVE, EAST LANSING, MI 48823-1843
(906) 236-0569
(866) 257-5918
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
C-03164
MI
104100000X
Social Worker
Primary
6801094413
MI
Other
Enumeration date
07/13/2012
Last updated
04/28/2021
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