Individual
ADAM JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSCSW, LMAC
Contact information
Practice address
1558 HAYES DR, MANHATTAN, KS 66502-5068
(785) 587-4315
(785) 587-4339
Mailing address
PO BOX 747, MANHATTAN, KS 66505-0747
(785) 587-4300
(785) 587-4377
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
008
KS
101YA0400X
Addiction (Substance Use Disorder) Counselor
616
KS
104100000X
Social Worker
7407
KS
1041C0700X
Clinical Social Worker
Primary
4234
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11974774
CAQH
—
05
—
200609070A
—
KS
Enumeration date
06/04/2009
Last updated
02/06/2019
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