Johnson, Stacey L
Johnson, Stacey L is an sole proprietor health care provider with primary practice located at 12160 Summerwood Dr , Concord Twp OH 44077-8525. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Johnson, Stacey L can be contacted via phone (216) 598-5202.Contact Information
Primary practice address
12160 Summerwood Dr
Concord Twp OH 44077-8525
Phone: (216) 598-5202
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Counselor | 101Y00000X | E.0003690 | Ohio |
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | E0003690 | Ohio |
Profile Details
| NPI number | 1790233898 |
|---|---|
| LBN Legal business name | Johnson, Stacey L |
| Credentials | LPCC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 17th, 2016 |
| Last updated | Jun 24th, 2026 - about 5 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790233898 | NPPES |
| Ohio | MEDICAID | 0187344 |
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