| Doctor Name: | ROMMEL JOHNSON |
| NPI Number: | 1619242096 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LPC |
| License Number: | 6401011898 |
| Business Practice Address: | 9133 Sunset Dr Apt 2 Berrien Springs, MI - 491031616 |
| Business Phone Number: | 2692773070 |
| Business Fax Number: | |
| Mailing Address: | Po Box 463, BERRIEN SPRINGS |
| State: | MI |
| Postal Code: | 491030463 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 03/19/2012 |
| NPI Last Update Date: | 03/19/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 6401011898 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |