Provider Demographics
NPI:1326362260
Name:JOHNSON, DENA RENE (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:DENA
Middle Name:RENE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22000 MARINE VIEW DR S
Mailing Address - Street 2:STE. 202
Mailing Address - City:DES MOINES
Mailing Address - State:WA
Mailing Address - Zip Code:98198-6233
Mailing Address - Country:US
Mailing Address - Phone:253-670-0777
Mailing Address - Fax:
Practice Address - Street 1:22000 MARINE VIEW DR S
Practice Address - Street 2:STE. 202
Practice Address - City:DES MOINES
Practice Address - State:WA
Practice Address - Zip Code:98198-6233
Practice Address - Country:US
Practice Address - Phone:253-670-0777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-22
Last Update Date:2010-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60136986101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health