Individual
TYLER JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW, LAC
Contact information
Practice address
2412 S CLIFF AVE, SIOUX FALLS, SD 57105-4031
(605) 322-4079
Mailing address
2412 S CLIFF AVE, SIOUX FALLS, SD 57105-4031
(605) 322-4079
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
23071956
SD
1041C0700X
Clinical Social Worker
Primary
6338
SD
Other
Enumeration date
09/18/2023
Last updated
09/18/2023
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