Johnna Layne Keck, SUDP CP- 61191773
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Ridgefield, WA
NPI 1497207252 · NPPES record last updated Aug 3, 2026
Key facts
- NPI
- 1497207252
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 61191773 (WA)
- Practice address
- 21810 NE 37TH Ave
Ridgefield, WA 98642-7747 - Phone
- (844) 777-9242
- Fax
- (360) 397-7477
- NPI assigned
- Oct 27, 2016
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61191773 | WA | MD | Addiction (Substance Use Disorder) Counselor |
| CO60660639 | WA | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| X Change Recovery | Addiction (Substance Use Disorder) | Current |
Accepting new patients |
| Xchange Behavioral Health Agency | Current |
Accepting new patients | |
| Pioneer Human Services | Past | Accepting new patients | |
| Pioneer Human Services | Past | Accepting new patients |
Locations
21810 NE 37th Ave
Ridgefield, WA 98642
Phone (844) 777-9242
3021 NE 72nd Dr
Ste 1
Vancouver, WA 98661
Phone (844) 777-9242
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor |
101YA0400X | 61191773 | WA | Yes |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CO60660639 | WA |
Addresses
Primary practice location
21810 NE 37TH Ave
Ridgefield, WA 98642-7747
Mailing address
21810 NE 37TH Ave
Ridgefield, WA 98642-7747
Phone (360) 605-4154
Other providers in Ridgefield, WA
- Jennifer Laura Johnson
- Tanna K Johnson
- Judith Kay Johnston
- Joint Ventures Therapeutics, PC
- Sarah Lanae Jones
- Candice Ketelsen
- Kmet Enterprises, PLLC
- Jasmin Nohealani Kobayashi-Kajiwara
- Laurie Lanza
- Sade Samone Larama
All providers in Ridgefield, WA · Addiction (Substance Use Disorder) Counselor in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 3, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.