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Individual

MICHELE JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, TEMP LMHC, CADC

Contact information

Practice address
501 SW ANKENY RD, ANKENY, IA 50023-9702
(515) 289-2272
(515) 289-0126
Mailing address
501 SW ANKENY RD, ANKENY, IA 50023-9702
(515) 289-2272
(515) 289-0126

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
14021
IA
101YM0800X
Mental Health Counselor
Primary
073865
IA

Other

Enumeration date
12/06/2013
Last updated
03/10/2017
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