1245525971 NPI number — MRS. MEGHANN ELIZABETH JOHNSON

Table of content: MRS. MEGHANN ELIZABETH JOHNSON (NPI 1245525971)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245525971 NPI number — MRS. MEGHANN ELIZABETH JOHNSON

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JOHNSON
Provider First Name:
MEGHANN
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
EDMUNDS
Provider Other First Name:
MEGHANN
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
L.M.S.W.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1245525971
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/04/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
221 HILL STREET
Provider Second Line Business Mailing Address:
PO BOX 1172
Provider Business Mailing Address City Name:
OSBURN
Provider Business Mailing Address State Name:
ID
Provider Business Mailing Address Postal Code:
83849
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
208-512-2522
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
123 MCKINLEY AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KELLOG
Provider Business Practice Location Address State Name:
ID
Provider Business Practice Location Address Postal Code:
83837
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
208-208-0115
Provider Business Practice Location Address Fax Number:
208-208-0115
Provider Enumeration Date:
06/10/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  LCSW-35318 , registered in the state of ID ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: LCSW-35318 , registered in the state of ID ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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