Provider Demographics
NPI:1225503139
Name:COLLEEN D JOHNSON, COUNSELING, LLC
Entity Type:Organization
Organization Name:COLLEEN D JOHNSON, COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/EMPLOYEE
Authorized Official - Prefix:
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:406-250-3845
Mailing Address - Street 1:PO BOX 584
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59912-0584
Mailing Address - Country:US
Mailing Address - Phone:406-250-3845
Mailing Address - Fax:406-892-4606
Practice Address - Street 1:305 1ST AVE W
Practice Address - Street 2:
Practice Address - City:COLUMBIA FALLS
Practice Address - State:MT
Practice Address - Zip Code:59912-3625
Practice Address - Country:US
Practice Address - Phone:406-250-3845
Practice Address - Fax:406-892-4606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-06
Last Update Date:2018-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty