person
Jacquelyn L Johnson, CADCII/QMHA-II
Addiction (Substance Use Disorder) Counselor in Gresham, Oregon
NPI 1700400769

Jacquelyn L Johnson is an Addiction (Substance Use Disorder) Counselor based in Portland, OR and is specialized in Addiction (Substance Use Disorder). Jacquelyn L Johnson practices in Gresham, OR and has the professional credentials of CADCII/QMHA-II. The NPI Number for Jacquelyn L Johnson is 1700400769 and holds a License No. 24-QMHA-II-000217 (Oregon).

The current practice location address for Jacquelyn L Johnson is 620 Ne 2Nd St, Gresham, OR and can be reached out via phone at 971-274-3757 and via fax at 503-912-5740.

Location: 620 Ne 2Nd St, Gresham, OR, 97205-1715
person
Provider Profile Details
NPI Number
1700400769
Provider Name
Jacquelyn L Johnson
Credential
CADCII/QMHA-II
Provider Entity Type
Individual
Gender
Female
Address
620 Ne 2Nd St, Gresham, OR, 97205-1715
Phone Number
971-274-3757
Fax Number
503-912-5740
Provider Enumeration Date
06/04/2020
Last Update Date
04/13/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
500783424 05 OR
500780897 05 OR
institution
Provider Business Practice Location Address Details
Address
620 Ne 2Nd St
City
State
Zip
97030-7514
Phone Number
971-274-3757
Fax Number
503-912-5740
person
Provider Business Mailing Address Details
Address
620 Ne 2Nd St
City
State
Zip
97030-7514
Phone Number
971-274-3757
Fax Number
503-912-5740
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
23-05-20274 (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.
24-QMHA-II-000217 (Oregon)
Definition
Definition to come...
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