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Individual

MR. RICHARD POWELL JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.A.,CADCIII,NCGCII,

Contact information

Practice address
15630 SE 90TH AVE, CLACKAMAS, OR 97015-9729
(971) 235-2954
(503) 675-9988
Mailing address
82 CERVANTES CIR, LAKE OSWEGO, OR 97035-1229

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
96-04-104
OR
101YM0800X
Mental Health Counselor

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
96-04-104
ADDICTION COUNSELOR CERTIFICATION BOARD OF OREGON
OR
Enumeration date
03/07/2007
Last updated
07/29/2008
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