MR. JACKIE JOHNSON SR., CADC II/QMHP-C, CSWA

Counselor - Addiction (Substance Use Disorder)

Active Individual
NPI: 1770745457

Practice Address

355 NW DIVISION ST
Gresham, OR 97030

Phone: (503) 231-2641

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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