Provider Demographics
NPI:1841169505
Name:JOHNSON, SALONE
Entity type:Individual
Prefix:
First Name:SALONE
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:458 NE DELAWARE AVE UNIT 415
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50021-6564
Mailing Address - Country:US
Mailing Address - Phone:702-600-2225
Mailing Address - Fax:
Practice Address - Street 1:458 NE DELAWARE AVE UNIT 415
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50021-6564
Practice Address - Country:US
Practice Address - Phone:702-600-2225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-31
Last Update Date:2025-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty