Jesse Johnston, PPC
Jesse Johnston, PPC is a Mental Health Counselor in Laramie, Wyoming. Qualified in 2024, 2 years ago. Licensed in Wyoming.
- Years since qualifying
- 2
- Licensed in
- WY
- In the registry since
- 2024
Practice location Address checks out
504 E Lyon StLaramie, WY 82072-2132
Phone: (307) 223-2172
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Specialties & licences
| Counselor (primary) | Taxonomy 101Y00000X · Licence PPC-1476 (WY) |
|---|
Record details
| NPI number | 1659194546 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | PPC |
| Sole proprietor | No |
| NPI enumerated | November 7, 2024 |
| Last updated in NPPES | November 7, 2024 |
| Certification date | November 7, 2024 |
| Mailing address | 2737 Nighthawk Dr, Laramie, WY 82072-1992 |
Medicare enrollment
| Medicare specialty | MENTAL HEALTH COUNSELOR |
|---|---|
| Medical school | OTHER |
| Graduated | 2024 (2 years in practice) |
| Accepts Medicare assignment | Not indicated |
| Practice locations | 2 on file with Medicare |
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