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Secret Ann Johnston, CADCI/CRM/PSS/QMHAR
Addiction (Substance Use Disorder) Counselor in Portland, Oregon
NPI 1306517420

Secret Ann Johnston is an Addiction (Substance Use Disorder) Counselor based in Portland, OR and is specialized in Addiction (Substance Use Disorder). Secret Ann Johnston practices in Portland, OR and has the professional credentials of CADCI/CRM/PSS/QMHAR. The NPI Number for Secret Ann Johnston is 1306517420 and holds a License No. 22-CRM-891 (Oregon).

The current practice location address for Secret Ann Johnston is 1631 Sw Coumbia St, Portland, OR and can be reached out via phone at 503-231-2641 and via fax at 503-231-1654.

Location: 1631 Sw Coumbia St, Portland, OR, 97205-1715
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Provider Profile Details
NPI Number
1306517420
Provider Name
Secret Ann Johnston
Credential
CADCI/CRM/PSS/QMHAR
Provider Entity Type
Individual
Gender
Female
Address
1631 Sw Coumbia St, Portland, OR, 97205-1715
Phone Number
503-231-2641
Fax Number
503-231-1654
Provider Enumeration Date
09/28/2021
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
500813291 05 OR
institution
Provider Business Practice Location Address Details
Address
1631 Sw Coumbia St
City
State
Zip
97201
Phone Number
503-231-2641
Fax Number
503-231-1654
person
Provider Business Mailing Address Details
Address
1631 Sw Coumbia St
City
State
Zip
97201
Phone Number
503-231-2641
Fax Number
503-231-1654
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
THW000106531 (Oregon)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
23-QMHA-R-3855 (Oregon)
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
License No.
22-CRM-891 (Oregon)
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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