Individual
MS. BETTY LOUANN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
2210 30TH AVE, KEARNEY, NE 68845-9687
(308) 440-8054
(308) 234-6604
Mailing address
PO BOX 1328, KEARNEY, NE 68848-1328
(308) 440-8054
(308) 234-6604
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LADC 305
NE
101YM0800X
Mental Health Counselor
Primary
LMHP 294
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025064900
—
NE
05
—
10025131000
—
NE
05
—
10025131100
—
NE
05
—
713406000
—
NE
01
—
84769
BLUE CROSS PROVIDER NUMBE
NE
Enumeration date
01/11/2007
Last updated
07/14/2016
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