Diana Johnson | Liberty, MO • PECOS Search

Diana Johnson

Counselor

Behavioral Health & Social Service Providers

2 N Main St, Suite D, Liberty, MO 64068-1638

PECOS Enrollment

Based on the most recent information from CMS, provider Diana Johnson does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1194038612
Provider Type
Individual
Full Name
Johnson, Diana
Credential
L.P.C.

Gender
Female
Sole Proprietor
Yes
Enumeration Date
7/26/2010
Last Updated
11/15/2010

Contact Information

Practice Location

2 N Main St, Suite D, Liberty, MO 64068-1638

Unlisted Fax

Mailing Location

2 N Main St, Suite D, Liberty, MO 64068-1638

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YP2500X Primary	Description Counselor Behavioral Health & Social Service Providers	License 2010038339 Missouri