Individual
JACLYN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14 LEAVITT RD, PITTSFIELD, NH 03263-3203
(603) 709-8560
Mailing address
14 LEAVITT RD, PITTSFIELD, NH 03263-3203
(603) 709-8560
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
174400000X
Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7706655Y0NH01
ANTHEM
NE
05
—
99003227
—
NH
Enumeration date
01/26/2009
Last updated
01/08/2025
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