Provider Demographics
NPI:1881722494
Name:JOHNS, REX DAVID (PHD, LPC,LAC, NCC)
Entity type:Individual
Prefix:
First Name:REX
Middle Name:DAVID
Last Name:JOHNS
Suffix:
Gender:M
Credentials:PHD, LPC,LAC, NCC
Other - Prefix:
Other - First Name:R. DAVID
Other - Middle Name:
Other - Last Name:JOHNS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5290 DTC PKWY STE 150
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2764
Mailing Address - Country:US
Mailing Address - Phone:303-642-6636
Mailing Address - Fax:303-432-5018
Practice Address - Street 1:5290 DTC PKWY STE 150
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2764
Practice Address - Country:US
Practice Address - Phone:303-642-6636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO222769101Y00000X
CO5317101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO841044412OtherGROUP TAX ID NUMBER