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NPI Code Detail

MEDICARE: SHAUNA JOHNSON LCSW

MEDICARE: SHAUNA 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
11041C0700XClinical Social Worker6061-CNV

General Provider Information

NPI Number : 1699068486
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAUNA JOHNSON LCSW
Provider Business Mailing Address
First Line : HC 61 BOX 101
Second Line :
City : HIKO
State : NV
Zip : 89017-9630
Country : US
Telephone Number : 702-556-2251
Fax Number : 775-726-3299
Provider Business Practice Location Address
First Line : 4455 ALLEN LN STE 130
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89031-2208
Country : US
Telephone Number : 702-385-1072
Fax Number : 702-385-3053
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/26/2011
Last Update Date : 03/05/2013

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