Provider Demographics
NPI:1215277231
Name:JOHNSON, AMBER C (MS, MA, LPC, NCC)
Entity type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:C
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MS, MA, LPC, NCC
Other - Prefix:MRS
Other - First Name:AMBER
Other - Middle Name:C
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2910 S JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48708-8407
Mailing Address - Country:US
Mailing Address - Phone:989-522-4870
Mailing Address - Fax:
Practice Address - Street 1:2910 S JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48708-8407
Practice Address - Country:US
Practice Address - Phone:989-220-3676
Practice Address - Fax:989-220-3676
Is Sole Proprietor?:No
Enumeration Date:2013-02-28
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401015058101YP2500X
MISC0000000889916101YS0200X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)