Provider Information for 1225568280
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LISA A JOHNSON LCPC
Sex: Female
NPI: 1225568280
Last Updated: 2023-11-27
Certification Date: 2020-06-30
Certification Date: 2020-06-30
Details
| Name | Value | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1225568280 | ||||||||||||||
| Enumeration Date | 2017-06-13 | ||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||
| Sole Proprietor | YES | ||||||||||||||
| Status | Active | ||||||||||||||
| Mailing Address | PO BOX 8506 KALISPELL, MT 59904-1506 United States Phone: 406-212-7865 | Fax: | ||||||||||||||
| Primary Practice Address | 43 WOODLAND PARK DR STE 5 KALISPELL, MT 59901-4676 United States Phone: 406-813-0441 | Fax: | ||||||||||||||
| Secondary Practice Address(es) | 75 CLAREMONT ST STE C | ||||||||||||||
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