Provider Demographics
NPI:1073080958
Name:JOHNSON, MEGAN SPRING (CDP)
Entity Type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:SPRING
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:CDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 COTTAGE AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:CASHMERE
Mailing Address - State:WA
Mailing Address - Zip Code:98815-1062
Mailing Address - Country:US
Mailing Address - Phone:425-269-2365
Mailing Address - Fax:
Practice Address - Street 1:220 EASTMONT AVE STE B
Practice Address - Street 2:
Practice Address - City:EAST WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98802-5306
Practice Address - Country:US
Practice Address - Phone:509-885-9090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-29
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP60292508101YA0400X
WACG60974918101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)