Provider Demographics
NPI:1467727594
Name:JOHNSON, JAMES HOLLIS (LPC 3093)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:HOLLIS
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:LPC 3093
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16015 COUNTY ROAD 49
Mailing Address - Street 2:
Mailing Address - City:LA SALLE
Mailing Address - State:CO
Mailing Address - Zip Code:80645-9713
Mailing Address - Country:US
Mailing Address - Phone:970-281-2478
Mailing Address - Fax:
Practice Address - Street 1:16015 COUNTY ROAD 49
Practice Address - Street 2:
Practice Address - City:LA SALLE
Practice Address - State:CO
Practice Address - Zip Code:80645-9713
Practice Address - Country:US
Practice Address - Phone:970-281-2478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-22
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3093101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional