MEDICARE: MRS. HELEN B. JOHNSON CMHC

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
1	101YP2500X	Professional Counselor	343853-6004	UT
2	101YM0800X	Mental Health Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	90196	OTHER	UT	PEHP

General Provider Information

NPI Number	:	1437353885
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HELEN B. JOHNSON CMHC

Provider Business Mailing Address
First Line	:	PO BOX 2041
Second Line	:
City	:	CEDAR CITY
State	:	UT
Zip	:	84721-2041
Country	:	US
Telephone Number	:	435-590-4411
Fax Number	:	435-865-9123

Provider Business Practice Location Address
First Line	:	2069 N MAIN ST STE 101
Second Line	:
City	:	CEDAR CITY
State	:	UT
Zip	:	84721-5602
Country	:	US
Telephone Number	:	435-590-4411
Fax Number	:	435-867-1199

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2007
Last Update Date	:	11/18/2024

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