Provider Demographics
NPI:1174660997
Name:JOHNSON, ROBERT J (LPC, LCADC)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:J
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:LPC, LCADC
Other - Prefix:MR
Other - First Name:ROBET
Other - Middle Name:
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:47 SHERBORNE STREET
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-4643
Mailing Address - Country:US
Mailing Address - Phone:973-857-0002
Mailing Address - Fax:973-857-0080
Practice Address - Street 1:280 BLOOMFIELD AVE
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:NJ
Practice Address - Zip Code:07044-2426
Practice Address - Country:US
Practice Address - Phone:973-857-0002
Practice Address - Fax:973-857-0080
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00069300101YA0400X
NJ37PC00036600101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJS1764OtherCERT MENTAL HLT SCREENER