Provider Demographics
NPI:1760661987
Name:JOHNSON, DAWN A (MS, LADC, LCAC)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:A
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MS, LADC, LCAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 N DUNCAN ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:KS
Mailing Address - Zip Code:67114-5704
Mailing Address - Country:US
Mailing Address - Phone:316-283-7829
Mailing Address - Fax:316-283-7449
Practice Address - Street 1:1309 N DUNCAN ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:KS
Practice Address - Zip Code:67114-5704
Practice Address - Country:US
Practice Address - Phone:316-283-7829
Practice Address - Fax:316-283-7449
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-25
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE645101YA0400X
NE8082101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health