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Star Marie Johnson
Peer Specialist in Longview, Washington
NPI 1235783366

Star Marie Johnson is a Peer Specialist based in Longview, WA. Star Marie Johnson practices in Longview, WA. The NPI Number for Star Marie Johnson is 1235783366 and holds a License No. CO61000223 (Washington).

The current practice location address for Star Marie Johnson is 748 14Th Ave, Longview, WA and can be reached out via phone at 360-200-5419 and via fax at 360-200-6736.

Location: 748 14Th Ave, Longview, WA, 98632
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1235783366
Provider Name
Star Marie Johnson
Credential
Provider Entity Type
Individual
Gender
Female
Address
748 14Th Ave, Longview, WA, 98632
Phone Number
360-200-5419
Fax Number
360-200-6736
Provider Enumeration Date
07/26/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2140147 05 WA
institution
Provider Business Practice Location Address Details
Address
748 14Th Ave
City
Longview
State
Washington
Zip
98632-2315
Phone Number
360-200-5419
Fax Number
360-200-6736
person
Provider Business Mailing Address Details
Address
748 14Th Ave
City
Longview
State
Washington
Zip
98632-2315
Phone Number
360-200-5419
Fax Number
360-200-6736
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
CG60987591 (Washington)
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
person
Provider's Taxonomy Details 2
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
CO61000223 (Washington)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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