Doctor Name: | MR. JAMES PAUL JOHNSON |
NPI Number: | 1336556349 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | BS, LADC, BCCR, ICS |
License Number: | 301697 |
Business Practice Address: | 140 Quail St Mahtomedi, MN - 551151941 |
Business Phone Number: | 6124542470 |
Business Fax Number: | 6124542188 |
Mailing Address: | 106 N Washington St, NEW ULM |
State: | MN |
Postal Code: | 560731838 |
Phone Number: | 5073822584 |
Fax Number: | 6124542188 |
NPI Enumeration Date: | 07/22/2014 |
NPI Last Update Date: | 07/22/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 301697 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |