Individual provider · Type 1 NPI

Jacob Ryne Johnson, COUNSELOR, PROF

Professional Counselor · Phoenix, AZ

NPI number 1184180655 Active

Practice location

16601 N 40th St Ste 216
Phoenix, AZ 85032-3354

Specialties and licenses

Taxonomy	Code	License
Professional Counselor Primary	101YP2500X	LPC-17622 (AZ)
Counselor	101Y00000X	LPC-17622 (AZ)

Professional Counselor: Definition to come...

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About NPI 1184180655

Jacob Ryne Johnson, COUNSELOR, PROF's National Provider Identifier is 1184180655, issued on Feb 20, 2019. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Phoenix, AZ. The record was last updated on Dec 4, 2025.