Provider Demographics
NPI:1407126519
Name:JOHNSON, RICHARD SCOTT (LCSW)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:SCOTT
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:663 WEST 950 SOUTH
Mailing Address - Street 2:
Mailing Address - City:BRIGHAM CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84302-2910
Mailing Address - Country:US
Mailing Address - Phone:435-734-9449
Mailing Address - Fax:435-723-8299
Practice Address - Street 1:625 S 300 E
Practice Address - Street 2:
Practice Address - City:BRIGHAM CITY
Practice Address - State:UT
Practice Address - Zip Code:84302-2910
Practice Address - Country:US
Practice Address - Phone:435-723-3176
Practice Address - Fax:435-723-8299
Is Sole Proprietor?:No
Enumeration Date:2012-01-05
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT78405013502171M00000X
UT7840501-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator