MRS. SHANNON MOORE JOHNSON LISAC BA NPI 1568550077

NPI Information

  • NPI: 1568550077
  • Provider Name: MRS. SHANNON MOORE JOHNSON, LISAC, BA
  • Classification: Counselor - 101YA0400X
  • Specialization: Addiction (Substance Use Disorder)
  • Entity Type: Individual
  • Address: 12033 AGENCY RD STE 730
    PARKER, AZ
    ZIP 85344
  • Phone: (928) 669-3256

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NPI Details

MRS. Shannon Moore Johnson, LISAC, BA is an addiction (substance use disorder) counselor in Parker, AZ. MRS. Shannon Moore Johnson, LISAC, BA NPI is 1568550077. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

12033 AGENCY RD STE 730
PARKER, AZ
ZIP 85344-718
Phone: (928) 669-3256
Fax: (928) 669-3252

The enumeration date for this NPI number is 10/10/2006 and was last updated on 4/24/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YA0400XCounselorAddiction (Substance Use Disorder)LISAC0725Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1893885OTHERARIZONAAHCCCS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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