Individual
BETHANY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC, LADC, CCS
Contact information
Practice address
342 NORTH ST APT 606, SACO, ME 04072-1857
(072) 812-4602
Mailing address
342 NORTH ST APT 606, SACO, ME 04072-1857
(207) 281-2460
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LC5947
ME
101YM0800X
Mental Health Counselor
Primary
CC5612
ME
Other
Enumeration date
10/02/2014
Last updated
10/16/2023
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