Individual
CHRYSTAL KAY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, CADC3, CGAC2
Contact information
Practice address
190 NW 4TH ST, PRINEVILLE, OR 97754-1820
(541) 447-6959
Mailing address
190 NW 4TH ST, PRINEVILLE, OR 97754-1820
(541) 447-6959
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
12-03-22
OR
101YM0800X
Mental Health Counselor
Primary
—
OR
Other
Enumeration date
03/07/2013
Last updated
01/30/2018
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