1821371873 NPI number — MISS KAREN K JOHNSON MSW, LCSW

Table of content: MISS KAREN K JOHNSON MSW, LCSW (NPI 1821371873)

General
Organization/Personal Information
Provider's Other Name Information
NPI Number Information
Provider's Business Mailing Address
Provider's Practice Location Mailing Address
Additional Information
Authorized Official
Provider Taxonomy Codes
Other Provider's Identifiers (legacy, non-NPI)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821371873 NPI number — MISS KAREN K JOHNSON MSW, LCSW

Organization/Personal Information

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:
JOHNSON

Provider First Name:
KAREN

Provider Middle Name:
K

Provider Name Prefix Text:
MISS

Provider Name Suffix Text:

Provider Credential Text:
MSW, LCSW

Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821371873

Entity Type Code:
Individual

Replacement NPI:

Last Update Date:
07/05/2019

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 1490

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:
WINDOW ROCK

Provider Business Mailing Address State Name:
AZ

Provider Business Mailing Address Postal Code:
86504

Provider Business Mailing Address Country Code:
US

Provider Business Mailing Address Telephone Number:
928-871-4012

Provider Business Mailing Address Fax Number:
928-729-4200

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7501 E THOMPSON PEAK PKWY UNIT 211

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:
SCOTTSDALE

Provider Business Practice Location Address State Name:
AZ

Provider Business Practice Location Address Postal Code:
85255-4532

Provider Business Practice Location Address Country Code:
US

Provider Business Practice Location Address Telephone Number:
602-818-1051

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:
09/26/2011

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: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Taxonomy code: 1041C0700X , with the licence number: LCSW-11716 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .