Johnson, Stacey L

Johnson, Stacey L is an sole proprietor health care provider with primary practice located at 12160 Summerwood Dr , Concord Twp OH 44077-8525. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Counselor. Behavioral Health & Social Service Providers / Counselor is her primary health care specialty. Johnson, Stacey L can be contacted via phone (216) 598-5202.

Contact Information

Primary practice address
12160 Summerwood Dr Concord Twp OH 44077-8525
Phone: (216) 598-5202
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X E0003690 Ohio
Behavioral Health & Social Service Providers / Counselor 101Y00000X E.0003690 Ohio

Profile Details

NPI number 1790233898
LBN Legal business name Johnson, Stacey L
Credentials LPCC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 17th, 2016
Last updated Oct 18th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790233898 NPPES
Ohio MEDICAID 0187344

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