Johnson, Shirley Renee
Johnson, Shirley Renee is an sole proprietor health care provider with primary practice located at 196 Mill St , Gahanna OH 43230-2647. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Johnson, Shirley Renee can be contacted via phone (614) 769-8571.Contact Information
Primary practice address
196 Mill St
Gahanna OH 43230-2647
Phone: (614) 769-8571
Fax: (614) 417-1451
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 041011 | Ohio |
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | E.1800985 | Ohio |
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | E.1800985 | Ohio |
Profile Details
| NPI number | 1770935009 |
|---|---|
| LBN Legal business name | Johnson, Shirley Renee |
| Credentials | LPCC-S, LICDC-CS |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 11th, 2016 |
| Last updated | Aug 27th, 2022 - about 2 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 | 1770935009 | NPPES |
| Ohio | MEDICAID | 0176372 |
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