Individual
NICOLE RENE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., L.P.C., S.A.C.
Contact information
Practice address
704 SAND LAKE RD STE 105, ONALASKA, WI 54650-2456
(608) 799-3881
(608) 440-2823
Mailing address
704 SAND LAKE RD STE 105, ONALASKA, WI 54650-2456
(608) 799-3881
(608) 440-2823
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
15560-131
WI
101YM0800X
Mental Health Counselor
Primary
3067-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40907500
—
WI
Enumeration date
06/12/2006
Last updated
03/30/2021
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