Provider Demographics
NPI:1487163317
Name:JOHNSON, COLE (MA, LMHP, CMFT)
Entity type:Individual
Prefix:
First Name:COLE
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:MA, LMHP, CMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7909 L ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68127-1725
Mailing Address - Country:US
Mailing Address - Phone:402-408-8388
Mailing Address - Fax:
Practice Address - Street 1:7909 L ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68127-1725
Practice Address - Country:US
Practice Address - Phone:402-408-8388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-22
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE11303101Y00000X
NE5502101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor