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General NPI Number Information
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NPI Number | 1487565412
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Entity Type | Individual
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Provider Name | TIMOTHY LEED JOHNSON JR. CSW, MSW
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Gender | Male
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Dates
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Enumeration Date | 09/16/2026
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Last Update Date | 09/16/2026
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Provider Practice Location Address
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Address Line | 168 N 1950 W
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City | SALT LAKE CITY
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State | UT
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Zip | 84116-3085
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Country | US
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Telephone | 801-213-8947
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Fax |
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Provider Business Mailing Address
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Address Line | 280 E BRIGHAM LN
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City | NORTH SALT LAKE
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State | UT
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Zip | 84054-2321
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Country | US
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Telephone | 210-305-3073
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 14291350-3502
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License Number State | UT
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