Cole Robert Johnson, LMHC, MHP, CMHS

Individual provider Active NPI Mental Health Counselor · Elma, WA

NPI 1962931139 · NPPES record last updated Jul 21, 2022

Key facts

NPI
1962931139
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
LH60651109 (WA)
Practice address
575 E Main Street
Elma, WA 98541
Phone
(360) 482-5358
NPI assigned
Jun 9, 2017
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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
LH60651109WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Health Resources Past
since Jul 24, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LH60651109 WA Yes

Addresses

Primary practice location

575 E Main Street
Elma, WA 98541

Mailing address

3857 Martin Way E
Olympia, WA 98506
Phone (360) 482-5358

Other providers in Elma, WA

All providers in Elma, WA · Mental Health Counselor in Washington

Sources for this page

Verify at the official NPI Registry.