Martin-Johnson, Carolyn M

Martin-Johnson, Carolyn M is an individual health care provider with primary practice located at 1499 Sixth St Innovative Counseling, Inc, Green Bay WI 54304-2252. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Social Worker. Behavioral Health & Social Service Providers / Social Worker is her primary health care specialty. Martin-Johnson, Carolyn M can be contacted via phone (920) 497-6161.

Contact Information

Primary practice address
1499 Sixth St Innovative Counseling, Inc Green Bay WI 54304-2252
Phone: (920) 497-6161
Fax: (920) 498-0476
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 14160 Wisconsin
Behavioral Health & Social Service Providers / Social Worker 104100000X 4155-125 Wisconsin

Profile Details

NPI number 1396894259
LBN Legal business name Martin-Johnson, Carolyn M
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 9th, 2007
Last updated Mar 8th, 2012 - about 12 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 1396894259 NPPES
Wisconsin MEDICAID 40965400

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