Provider Demographics
NPI:1821371873
Name:JOHNSON, KAREN K (MSW, LCSW)
Entity Type:Individual
Prefix:MISS
First Name:KAREN
Middle Name:K
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1490
Mailing Address - Street 2:
Mailing Address - City:WINDOW ROCK
Mailing Address - State:AZ
Mailing Address - Zip Code:86504
Mailing Address - Country:US
Mailing Address - Phone:928-871-4012
Mailing Address - Fax:928-729-4200
Practice Address - Street 1:7501 E THOMPSON PEAK PKWY UNIT 211
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-4532
Practice Address - Country:US
Practice Address - Phone:602-818-1051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-26
Last Update Date:2019-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
AZLCSW-117161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical