Individual
ADAM EDWARD JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LPC, NCC
Contact information
Practice address
515 MOUNT RAINIER ST, BERTHOUD, CO 80513-1482
(847) 819-2458
Mailing address
PO BOX 1132, BERTHOUD, CO 80513-2132
(847) 819-2458
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC.0011855
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000183633
—
CO
Enumeration date
08/22/2019
Last updated
09/18/2020
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