Individual
HEATHER MARIE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
8382 N WAYNE DR, HAYDEN, ID 83835-6028
(208) 719-9110
(208) 209-6026
Mailing address
8382 N WAYNE DR, HAYDEN, ID 83835-6028
(208) 719-9110
(208) 209-6026
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
40713
ID
101YM0800X
Mental Health Counselor
LMSW36887
ID
1041C0700X
Clinical Social Worker
Primary
LCSW40713
ID
Other
Enumeration date
01/16/2018
Last updated
01/22/2026
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