Provider Demographics
NPI:1235971631
Name:JOHNSON, SONIA (CMHC)
Entity type:Individual
Prefix:
First Name:SONIA
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 S 500 W APT 429
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84101-1551
Mailing Address - Country:US
Mailing Address - Phone:281-224-0510
Mailing Address - Fax:
Practice Address - Street 1:1825 S CAMPUS DR
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84112-0900
Practice Address - Country:US
Practice Address - Phone:801-702-2665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11929872-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health