Individual
JUDITH R JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, LAT
Contact information
Practice address
1368 N 19TH ST, LARAMIE, WY 82072-2313
(307) 760-7216
Mailing address
1368 N 19TH ST, LARAMIE, WY 82072-2313
(307) 760-7216
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
237
WY
101YP2500X
Professional Counselor
Primary
447
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
237
LAT
WY
01
—
237290
MAC
—
01
—
39374
NCC
—
01
—
447
LPC
WY
Enumeration date
05/14/2021
Last updated
05/14/2021
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