Individual
MRS. ANGELA NICHOELE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLPC, LBSW
Contact information
Practice address
677A EAST MAIN, CENTREVILLE, MI 49032
(269) 467-1000
Mailing address
413 N GRAND ST STE C, SCHOOLCRAFT, MI 49087-9203
(269) 858-8722
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401006332
MI
1041C0700X
Clinical Social Worker
6802076432
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1708146
—
MI
Enumeration date
12/29/2008
Last updated
05/24/2024
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