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NPI Code Detail

MEDICARE: MYA R JOHNSON LCSW

MEDICARE: MYA R 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
1104100000XSocial Worker126747WI
21041C0700XClinical Social Worker11515-123WI

General Provider Information

NPI Number : 1932765203
Entity Type Code : Individual
Provider Name (Legal Business Name) : MYA R JOHNSON LCSW
Provider Business Mailing Address
First Line : 4800 N SCOTTSDALE RD STE 2500
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85251-7630
Country : US
Telephone Number : 262-999-3495
Fax Number :
Provider Business Practice Location Address
First Line : 2901 W BELTLINE HWY STE 301
Second Line :
City : MADISON
State : WI
Zip : 53713-4228
Country : US
Telephone Number : 262-789-1191
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/13/2019
Last Update Date : 07/15/2025

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Directions to “ MYA R JOHNSON LCSW” Practice Location

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