Provider Demographics
NPI:1447729264
Name:JOHNSON, JODY LEIGH (LMHC)
Entity type:Individual
Prefix:MRS
First Name:JODY
Middle Name:LEIGH
Last Name:JOHNSON
Suffix:
Gender:
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5980 E POLELINE AVE
Mailing Address - Street 2:
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854-8353
Mailing Address - Country:US
Mailing Address - Phone:509-209-0947
Mailing Address - Fax:877-268-9105
Practice Address - Street 1:720 N ARGONNE RD STE E
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99212-2794
Practice Address - Country:US
Practice Address - Phone:509-209-0947
Practice Address - Fax:877-268-9105
Is Sole Proprietor?:No
Enumeration Date:2018-11-21
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60161600101Y00000X
171M00000X
WA00054941225C00000X
WALH60161600101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor