Provider Demographics
NPI:1215192448
Name:JOHNSON, AILEEN S (BA)
Entity Type:Individual
Prefix:
First Name:AILEEN
Middle Name:S
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1955 ULSTER ST
Mailing Address - Street 2:453
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-2065
Mailing Address - Country:US
Mailing Address - Phone:303-895-9592
Mailing Address - Fax:
Practice Address - Street 1:2111 CHAMPA ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-2529
Practice Address - Country:US
Practice Address - Phone:303-293-6509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health