Individual
MR. ROBERT GERARD JOHNSON SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC, SPADA, CAAC
Contact information
Practice address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 281-6363
(616) 455-5460
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 281-6363
(616) 455-5460
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
C-01218
MI
101YP2500X
Professional Counselor
Primary
6401008579
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6401008579
PROFESSIONAL COUNSELOR
MI
01
—
C-012118 CAAC
CERTIFIED ADVANCED ADDICTION COUNSELOR
MI
01
—
NCFR
CERTIFIED FAMILY LIFE EDUCATOR CFLE- NATIONAL COUNSEL ON FAMILY RELATIONS
—
Enumeration date
03/14/2007
Last updated
08/30/2010
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