Provider Demographics
NPI:1407272883
Name:JOHNS, DOREEN BETTY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DOREEN
Middle Name:BETTY
Last Name:JOHNS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:DOREEN
Other - Middle Name:BETTY
Other - Last Name:JOHNS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DOREEN JOHNS, LCSW
Mailing Address - Street 1:42679 LOSCHEIDER RD
Mailing Address - Street 2:
Mailing Address - City:RONAN
Mailing Address - State:MT
Mailing Address - Zip Code:59864-8859
Mailing Address - Country:US
Mailing Address - Phone:406-240-0038
Mailing Address - Fax:
Practice Address - Street 1:1 EISENHOWER ST SW
Practice Address - Street 2:
Practice Address - City:RONAN
Practice Address - State:MT
Practice Address - Zip Code:59864-3302
Practice Address - Country:US
Practice Address - Phone:406-240-0038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-10
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCSW-LIC-76611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical