Individual
SALLY A JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, CSAC
Contact information
Practice address
903 MINERAL POINT AVE, JANESVILLE, WI 53548-2970
(608) 756-5555
(608) 756-0174
Mailing address
903 MINERAL POINT AVE, JANESVILLE, WI 53548-2970
(608) 756-5555
(608) 756-0174
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
4273
WI
101YP2500X
Professional Counselor
Primary
14553
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1215081542
BCBSWI
WI
05
—
1215081542
—
WI
05
—
39386700
—
WI
01
—
JOHNSSAL
MERCYCARE INSURANCE
WI
Enumeration date
01/23/2007
Last updated
11/25/2013
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