Clark Mitchell Johnson, B.S. CADC II

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

101YAO4OOX Issued in OR

Practice address

58646 McNulty Way
Saint Helens, OR 97051-6210

Phone

(503) 397-5211

NPI assigned

Jul 30, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185753600000",
    "number": "1720278310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58646 MCNULTY WAY",
            "city": "SAINT HELENS",
            "state": "OR",
            "postal_code": "970516210",
            "telephone_number": "503-397-5211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58646 MCNULTY WAY",
            "city": "SAINT HELENS",
            "state": "OR",
            "postal_code": "970516210",
            "telephone_number": "503-397-5211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CLARK",
        "middle_name": "MITCHELL",
        "name_prefix": "Mr.",
        "credential": "B.S.  CADC II",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-30",
        "last_updated": "2007-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "101YAO4OOX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lucca Jenkins-Law
• Rebecca Helen Jenkins, M.S.W
• Crystal M Jensen, LMT OR 15194
• Daniel D. Jewell, LPC
• Susan Carol Johnson-Doerr, AS
• David Jeremiah Johnson
• Justin Tyler Johnson
• Wayne Harold Johnston
• Kayleen Jones
• Lisa Margaret Jones, PA

• Addiction (Substance Use Disorder) Counselor in Saint Helens, OR
• Providers in Saint Helens, OR by specialty
• Addiction (Substance Use Disorder) Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.