Provider Demographics
NPI:1427848522
Name:JOHNSON, SARAH BETH (MACCC-SLP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:BETH
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MACCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 NORMANDY RD
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-6638
Mailing Address - Country:US
Mailing Address - Phone:740-352-6423
Mailing Address - Fax:
Practice Address - Street 1:227 GOLDEN ROCKET DR
Practice Address - Street 2:
Practice Address - City:WELLSTON
Practice Address - State:OH
Practice Address - Zip Code:45692-9605
Practice Address - Country:US
Practice Address - Phone:740-384-2251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.05555235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist