Individual
EMILY ROTH JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
500 LAKE STEEL STREET, GREEN LAKE, WI 54941
(920) 294-4070
(920) 294-4139
Mailing address
PO BOX 588, GREEN LAKE, WI 54941-0588
(920) 294-4070
(920) 294-4139
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
3349125
WI
101YP2500X
Professional Counselor
Primary
3349125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40994500
—
WI
Enumeration date
03/06/2007
Last updated
09/11/2025
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