MR. JACKIE JOHNSON SR., CADC II/QMHP-C, CSWA
Counselor - Addiction (Substance Use Disorder)
Active
Individual
NPI: 1770745457
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Counselor - Addiction (Substance Use Disorder) | 101YA0400X | Yes | 00-11-45 (OR) |
| Counselor - Mental Health | 101YM0800X | No | 24-QMHPC-001514 (OR) |
| Social Worker - Clinical | 1041C0700X | No | A11750 (OR) |
Frequently Asked Questions
NPI 1770745457 is the National Provider Identifier for MR. JACKIE JOHNSON SR., CADC II/QMHP-C, CSWA, a Counselor - Addiction (Substance Use Disorder) provider located in Gresham, OR. This NPI was enumerated on June 25, 2008.
MR. JACKIE JOHNSON SR., CADC II/QMHP-C, CSWA practices at 355 NW DIVISION ST, Gresham, OR 97030.
Quick Facts
- NPI
- 1770745457
- Type
- Individual
- Enumerated
- Jun 25, 2008
- Last Updated
- Jan 30, 2025
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