Provider Demographics
NPI:1447798285
Name:JOHNSON, CHRISTINA MARIE (LMHC, CADC)
Entity type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:MARIE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LMHC, CADC
Other - Prefix:MS
Other - First Name:CRISSI
Other - Middle Name:MARIE
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMHC, CADC
Mailing Address - Street 1:6600 WESTOWN PKWY
Mailing Address - Street 2:SUITE 240
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-7707
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6600 WESTOWN PKWY
Practice Address - Street 2:SUITE 240
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-7707
Practice Address - Country:US
Practice Address - Phone:515-402-4394
Practice Address - Fax:515-401-1086
Is Sole Proprietor?:No
Enumeration Date:2017-02-01
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA076372101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health