Healthcare Provider Details

I. General information

NPI: 1780970848
Provider Name (Legal Business Name): SHEILA LYNN JOHNSEN MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2011
Last Update Date: 06/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 S MONTANA ST
BUTTE MT
59701-2840
US

IV. Provider business mailing address

205 E PARK AVE
ANACONDA MT
59711-2340
US

V. Phone/Fax

Practice location:
  • Phone: 406-533-2969
  • Fax: 406-782-2045
Mailing address:
  • Phone: 406-563-8117
  • Fax: 406-563-5956

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: