JACQUELYN L JOHNSON CADC II/QMHA-II
NPI 1700400769
Counselor - Addiction (Substance Use Disorder) in Gresham, OR

Q: What is Jacquelyn Johnson's NPI number?

The NPI number for Jacquelyn Johnson is 1700400769. It was assigned to this individual provider in the NPPES registry on June 4, 2020. The provider is also known as Jackie L Johnson Cadc Ii/Qmha-Ii.

Q: What is Jacquelyn Johnson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Q: When was this NPI record last updated?

The NPPES record for Jacquelyn Johnson was last updated on March 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 04, 2020

620 NE 2ND ST, GRESHAM, OR 97030(971) 274-3757(503) 912-5740 Get Directions Write a Review

NPPES record last updated: March 11, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 10, 2023, Oct 6, 2022, Jul 7, 2022 and 2 more (5 updates tracked since 2020).

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About Jacquelyn L Johnson Cadc Ii/qmha-ii NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACQUELYN L JOHNSON CADC II/QMHA-II (NPI 1700400769) is an individual addiction (substance use disorder) provider in Gresham, Oregon, licensed in Oregon (23-05-20274) and active in the NPI registry since June 2020.

NPPES Registry Identity

NPI1700400769

Entity TypeIndividualFemale

Primary Taxonomy101YA0400X

Provider Legal NameJACQUELYN L JOHNSONCredential: CADC II/QMHA-II

Location Address620 NE 2ND STGresham, OR 97030-7514

Mailing Address1776 Sw Madison StPortland, OR 97205-1715 · (503) 224-1044 · Fax (503) 621-2235

Phone(971) 274-3757

Fax(503) 912-5740

Sole ProprietorNo

Enumeration DateJune 4, 2020

Last NPPES UpdateMarch 11, 20245 updates tracked since enumeration

NPPES CertifiedMarch 11, 2024

✔ NPI 1700400769 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers

Taxonomy Code101YA0400X

License✔ Licensed in OR · 23-05-20274

Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License 24-QMHA-II-000217 (OR)

620 NE 2ND ST, Gresham, OR 97030

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Other Names 1

Other Name (5)Jackie L Johnson Cadc Ii/qmha-ii

Other Identifiers 2

Medicaid500783424OR

Medicaid500780897OR

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KATHY A LITVIN CSWA/QMHP-C

Counselor (Mental Health)