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Organization

ENLIGHTENED PATH PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KIMBERLIE JOHNSON LCSW (OWNER)
(385) 233-0672
Entity
Organization

Contact information

Practice address
1881 N 1120 W, PROVO, UT 84604-1180
(385) 233-0672
Mailing address
1463 S 3750 E, SPANISH FORK, UT 84660-6387
(385) 225-5810

Taxonomy

Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
261QM0855X
Adolescent and Children Mental Health Clinic/Center

Other

Enumeration date
07/29/2025
Last updated
07/29/2025
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