Donnell Marie Johansen

Individual provider Active NPI Community Health Worker · Ephraim, UT

NPI 1962967232 · NPPES record last updated Sep 11, 2026

Key facts

NPI
1962967232
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Worker 172V00000X
Practice address
152 N 400 W
Ephraim, UT 84627-5549
Phone
(435) 283-8400
Fax
(435) 283-8401
NPI assigned
Jan 31, 2019
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Central Utah Counseling Center Mental Health Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Recreational Therapist Assistant 226000000X
Community Health Worker 172V00000X UT Yes

Addresses

Primary practice location

152 N 400 W
Ephraim, UT 84627-5549

Mailing address

152 N 400 W
Ephraim, UT 84627-5549
Phone (435) 283-8400

Other providers in Ephraim, UT

All providers in Ephraim, UT · Community Health Worker in Utah

Sources for this page

Verify at the official NPI Registry.