Chasity Daugherty7 Johnson, LEP, NCSP

Individual provider Active NPI School Psychologist · Tenino, WA

NPI 1568041192 · NPPES record last updated Apr 2, 2021

Key facts

NPI
1568041192
Entity type
Individual (NPI type 1)
Primary specialty
School Psychologist 103TS0200X
License
3744 (CA)
Practice address
500 W 2ND Ave
Tenino, WA 98589
Phone
(360) 264-3400
NPI assigned
Apr 2, 2021
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
3744CAMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist
Group: 193400000X SINGLE SPECIALTY GROUP
103TS0200X 3744 CA Yes

Addresses

Primary practice location

500 W 2ND Ave
Tenino, WA 98589

Mailing address

8265 Balsa Ave
Yucca Valley, CA 92284-6112
Phone (304) 416-4339

Other providers in Tenino, WA

All providers in Tenino, WA · School Psychologist in Washington

Sources for this page

Verify at the official NPI Registry.