Healthcare Provider Details
I. General information
NPI: 1437353885
Provider Name (Legal Business Name): HELEN B. JOHNSON CMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/12/2007
Last Update Date: 11/18/2024
Certification Date: 11/18/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2069 N MAIN ST STE 101
CEDAR CITY UT
84721-5602
US
IV. Provider business mailing address
PO BOX 2041
CEDAR CITY UT
84721-2041
US
V. Phone/Fax
- Phone: 435-590-4411
- Fax: 435-867-1199
- Phone: 435-590-4411
- Fax: 435-865-9123
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | 343853-6004 |
| License Number State | UT |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 90196 |
| Identifier Type | OTHER |
| Identifier State | UT |
| Identifier Issuer | PEHP |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: