Individual
LISA MARIE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, LAC
Contact information
Practice address
1109 4TH ST, GARRETSON, SD 57030-2011
(605) 212-2946
Mailing address
1109 4TH ST, GARRETSON, SD 57030-2011
(605) 212-2946
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
7051307
SD
101YP2500X
Professional Counselor
Primary
LPC1185
SD
Other
Enumeration date
08/07/2024
Last updated
08/07/2024
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