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Nicole Renee Johnson
Peer Specialist in Longview, Washington
NPI 1407414709

Nicole Renee Johnson is a Peer Specialist based in Chehalis, WA. Nicole Renee Johnson practices in Longview, WA. The NPI Number for Nicole Renee Johnson is 1407414709 and holds a License No. CG60971822 (Washington).

The current practice location address for Nicole Renee Johnson is 1338 Commerce Ave Ste 303, Longview, WA and can be reached out via phone at 360-261-6930.

Location: 1338 Commerce Ave Ste 303, Longview, WA, 98532-0378
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1407414709
Provider Name
Nicole Renee Johnson
Credential
Provider Entity Type
Individual
Gender
Female
Address
1338 Commerce Ave Ste 303, Longview, WA, 98532-0378
Phone Number
360-261-6930
Fax Number
Provider Enumeration Date
05/31/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1338 Commerce Ave Ste 303
City
Longview
State
Washington
Zip
98632-3726
Phone Number
360-261-6930
Fax Number
person
Provider Business Mailing Address Details
Address
1338 Commerce Ave Ste 303
City
Longview
State
Washington
Zip
98632-3726
Phone Number
360-261-6930
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
CG60971822 (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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