Provider Demographics
NPI:1669068268
Name:JOHNSON, SCOTT MATTHEW (LCSW)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:MATTHEW
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 1:7465 E 1ST AVE STE B
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-6877
Mailing Address - Country:US
Mailing Address - Phone:303-326-0645
Mailing Address - Fax:
Practice Address - Street 1:7465 E 1ST AVE STE B
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-6877
Practice Address - Country:US
Practice Address - Phone:303-326-0645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-17
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical