Provider Demographics
NPI:1124437538
Name:BARBARA LOHMAN JOHNSON, LCSW, BCD
Entity type:Organization
Organization Name:BARBARA LOHMAN JOHNSON, LCSW, BCD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:J
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:719-576-1978
Mailing Address - Street 1:2975 BROADMOOR VALLEY RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-4466
Mailing Address - Country:US
Mailing Address - Phone:719-576-1978
Mailing Address - Fax:719-576-1979
Practice Address - Street 1:2975 BROADMOOR VALLEY RD
Practice Address - Street 2:SUITE 103
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-4466
Practice Address - Country:US
Practice Address - Phone:719-576-1978
Practice Address - Fax:719-576-1979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-11
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO987015101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO987015OtherLCSW
CO1912036153OtherSOLE PROPRIETOR NPI