Kimberlie Jo Johnson

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

1881 N 1120 W
Provo, UT 84604-1180

Phone

(435) 248-2089

Fax

(801) 207-5104

NPI assigned

Dec 4, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Enlightened Path PLLC

  • Adult Mental Health Clinic/Center
  • Provo, UT
  • NPI 1487537189
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1575417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775692800000",
    "number": "1104463694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1881 N 1120 W",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846041180",
            "telephone_number": "435-248-2089",
            "fax_number": "801-207-5104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1881 N 1120 W",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846041180",
            "telephone_number": "435-248-2089",
            "fax_number": "801-207-5104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KIMBERLIE",
        "middle_name": "JO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-04",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juana Dafne Johnson
• Katelyn Johnson
• Keiko Osako Johnson
• Kevin Johnson, MSN, APRN, FNP-C
• Kim Leroy Johnson, HSW
• Kristen Johnson, RD
• Lauren Johnson
• Louise H Johnson, LCSW
• Melanie Johnson
• Michael Johnson, APRN

• Clinical Social Worker in Provo, UT
• Providers in Provo, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.