Individual
MYA R JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2901 W BELTLINE HWY STE 301, MADISON, WI 53713-4228
(262) 789-1191
Mailing address
4800 N SCOTTSDALE RD STE 2500, SCOTTSDALE, AZ 85251-7630
(262) 999-3495
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
126747
WI
1041C0700X
Clinical Social Worker
Primary
11515-123
WI
Other
Enumeration date
05/13/2019
Last updated
07/15/2025
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