person
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
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
State
Zip
98632-3726
Phone Number
360-261-6930
Fax Number
person
Provider Business Mailing Address Details
Address
1338 Commerce Ave Ste 303
City
State
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
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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