Johnson, Emily Roth
Johnson, Emily Roth is an individual health care provider with primary practice located at 500 Lake Steel Street , Green Lake WI 54941. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Johnson, Emily Roth can be contacted via phone (920) 294-4070.Contact Information
Primary practice address
500 Lake Steel Street
Green Lake WI 54941
Phone: (920) 294-4070
Fax: (920) 294-4139
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 3349125 | Wisconsin |
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 3349125 | Wisconsin |
Profile Details
| NPI number | 1316077860 |
|---|---|
| LBN Legal business name | Johnson, Emily Roth |
| Credentials | Licensed Professional Counselor (LPC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 6th, 2007 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316077860 | NPPES |
| Wisconsin | MEDICAID | 40994500 |
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