Provider Demographics
NPI:1225792526
Name:JOHNSON, AARON THOMAS (CADC)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:THOMAS
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 MOLLISON WAY
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-5811
Mailing Address - Country:US
Mailing Address - Phone:207-312-6860
Mailing Address - Fax:207-312-6863
Practice Address - Street 1:24 DUNN ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:ME
Practice Address - Zip Code:04210-6821
Practice Address - Country:US
Practice Address - Phone:207-784-2901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-25
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC8766101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)