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NPI Code Detail

MEDICARE: GIOVONIE JOHNSON

MEDICARE:   GIOVONIE  JOHNSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1770431843
Entity Type Code : Individual
Provider Name (Legal Business Name) : GIOVONIE JOHNSON
Provider Business Mailing Address
First Line : 931 W OWENS AVE STE 155
Second Line :
City : LAS VEGAS
State : NV
Zip : 89106-2583
Country : US
Telephone Number : 702-659-0481
Fax Number : 702-659-0481
Provider Business Practice Location Address
First Line : 931 W OWENS AVE STE 155
Second Line :
City : LAS VEGAS
State : NV
Zip : 89106-2583
Country : US
Telephone Number : 702-659-0481
Fax Number : 702-659-0481
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2026
Last Update Date : 03/17/2026

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Directions to “ GIOVONIE JOHNSON ” Practice Location

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