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NPI Code Detail

MEDICARE: AUBREE M JOHNSON LCSW

MEDICARE: AUBREE M JOHNSON LCSW
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
1101Y00000XCounselor

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000055266OTHERUTMEDICARE PIN
2260022408OTHERUTRAILRAOD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1679067367
Entity Type Code : Individual
Provider Name (Legal Business Name) : AUBREE M JOHNSON LCSW
Provider Business Mailing Address
First Line : 1015 HISLOP DR
Second Line :
City : OGDEN
State : UT
Zip : 84404-5313
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2825 E COTTONWOOD PKWY STE 500
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84121-7060
Country : US
Telephone Number : 646-941-7645
Fax Number : 929-596-7897
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2018
Last Update Date : 10/22/2024

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