Basic Information
| Provider Information | |||||||||
| NPI: | 1902041692 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JOHNS | ||||||||
| FirstName: | MARGARET | ||||||||
| MiddleName: | ANN | ||||||||
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| Credential: | MSW, CADCI | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 790 | ||||||||
| Address2: | |||||||||
| City: | STEVENSON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 986480790 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5094273850 | ||||||||
| FaxNumber: | 8662972364 | ||||||||
| Practice Location | |||||||||
| Address1: | 710 SW ROCK CREEK DR. | ||||||||
| Address2: | |||||||||
| City: | STEVENSON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98648 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5094273850 | ||||||||
| FaxNumber: | 8662942364 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/09/2008 | ||||||||
| LastUpdateDate: | 01/04/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | 05-07-34 | OR | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 1041C0700X | LW60195851 | WA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.