Individual
MR. CODY WILLIAM REDD JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC, NCC
Contact information
Practice address
156 MCCLURE AVE, NAMPA, ID 83651-2025
(208) 323-9600
(208) 466-5359
Mailing address
PO BOX 9, NAMPA, ID 83653-0009
(208) 467-4431
(208) 467-7684
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LCPC-10144
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LPC-6773
—
ID
Enumeration date
03/09/2018
Last updated
03/15/2024
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