Mr. Jackie Eugene Johnson Sr. is a Gresham, Oregon based counselor who is specialized as Addiction (Substance Use Disorder) Counselor. Active license number of Mr. Jackie Eugene Johnson Sr. is 00-11-45 for Addiction (Substance Use Disorder) Counselor in Oregon. His current practice location is 355 Nw Division St, Gresham. Patients can book an appointment with him at 503-231-2641.
Mr. Jackie Eugene Johnson Sr. is a licensed mental health therapist who help individuals struggling with addiction of alcohol, drug, or other substance use disorder. He helps his clients by manage and overcome the psychological, emotional, and behavioral challenges related to substance use. Counselors also work closely with families and support systems to help them better understand their loved one’s illness. SUD counselors help to promote long-term sobriety, emotional stability, and overall mental wellness for both the individual and their family.
Complete Profile:
Mr. Jackie Eugene Johnson Sr. speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
Name:
Mr. Jackie Eugene Johnson Sr.
Specialization:
Addiction (Substance Use Disorder) Counselor
Gender:
Male
Credentials:
CADC II/QMHP-C, CSWA
Accepts Medicare Assignment:
No
Practice Address:
355 Nw Division St, Gresham, Oregon, 97030-5523
Phone:
503-231-2641
Fax:
503-231-1654
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
NPI Number:
1770745457
NPI Enumeration Date:
25 Jun, 2008
NPI Last Update On:
30 Jan, 2025
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Mr. Jackie Eugene Johnson Sr. are as mentioned below.
License Number
Specialization
State
Status
00-11-45
Addiction (Substance Use Disorder) Counselor
Oregon
Primary
17-CRM-078
Addiction (Substance Use Disorder) Counselor
Oregon
Secondary
24-QMHPC-001514
Mental Health Counselor
Oregon
Secondary
A11750
Social Worker
Oregon
Secondary
Other Medical Identifiers:
Other legacy medical identifiers associated with Mr. Jackie Eugene Johnson Sr. such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
500800849
Medicaid
Oregon
500801135
Medicaid
Oregon
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
1776 Sw Madison St, Portland, Oregon
Zip:
97205-1715
Phone Number:
503-224-1044
Fax Number:
503-621-2235
Patients can reach Mr. Jackie Eugene Johnson Sr. at 355 Nw Division St, Gresham, Oregon or can call to book an appointment on 503-231-2641. *Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 09 June, 2025.