Provider Demographics
NPI:1174083778
Name:JOHNSON, CATANIA (ACMHC, NCC)
Entity type:Individual
Prefix:MRS
First Name:CATANIA
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:ACMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7478 S 2540 W
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84084-3873
Mailing Address - Country:US
Mailing Address - Phone:801-380-7955
Mailing Address - Fax:
Practice Address - Street 1:1901 PROSPECTOR AVE STE 30
Practice Address - Street 2:
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84060-7524
Practice Address - Country:US
Practice Address - Phone:435-268-2228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-21
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5650350-6009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health