Individual
MARLON JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC, LICDC
Contact information
Practice address
1744 PAYNE AVE, CLEVELAND, OH 44114-2910
(216) 623-6555
Mailing address
4314 S PARKSIDE DR, BROOKLYN, OH 44144-2724
(216) 970-8307
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LICDC.162004
OH
101YP2500X
Professional Counselor
Primary
E.2202779
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0391321
—
OH
Enumeration date
11/01/2016
Last updated
07/19/2022
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