Individual provider Active NPI

Amy L Johnson, CSW

  • Mental Health Counselor
  • Salt Lake City, UT
National Provider Identifier
1790458248
Registry record updated Jul 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
123100283502 Issued in UT
Practice address
Kathleen Lakey and Associates
275 East South Temple, Ste 103
Salt Lake City, UT 84111
Phone
(385) 218-8266
Fax
(801) 364-1433
NPI assigned
Jul 30, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 123100283502 UT Primary

Addresses

Primary practice location

Kathleen Lakey and Associates
275 East South Temple, Ste 103
Salt Lake City, UT 84111

Mailing address

275 E South Temple Ste 103
Salt Lake City, UT 84111-1323
Phone (385) 218-8266

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
123100283502UTMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1627603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627603200000",
    "number": "1790458248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 E SOUTH TEMPLE STE 103",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841111323",
            "telephone_number": "385-218-8266",
            "fax_number": "801-364-1433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "KATHLEEN LAKEY AND ASSOCIATES",
            "address_2": "275 EAST SOUTH TEMPLE, STE 103",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84111",
            "telephone_number": "385-218-8266",
            "fax_number": "801-364-1433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "AMY",
        "middle_name": "L",
        "credential": "CSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-30",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "123100283502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2021; 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.