Individual
MATTHEW JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC, SAC-IT
Contact information
Practice address
1622 CHESTNUT ST, WEST BEND, WI 53095-3014
(262) 306-9800
Mailing address
W168N9096 GARDEN AVE, MENOMONEE FALLS, WI 53051-2114
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
20000-130
WI
101YM0800X
Mental Health Counselor
7352-226
WI
101YP2500X
Professional Counselor
Primary
11882-125
WI
Other
Enumeration date
09/19/2023
Last updated
06/26/2025
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