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STACEY LYNN JOHANSON
NPI 1194476895
Residential Treatment Facility, Emotionally Disturbed Children in Ephraim, UT

Active since January 13, 2022

NPPES record last updated: January 13, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Stacey Lynn Johanson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STACEY LYNN JOHANSON (NPI 1194476895) is an individual residential treatment facility, emotionally disturbed children provider in Ephraim, Utah and active in the NPI registry since January 2022.

NPPES Registry Identity

NPI1194476895
Entity TypeIndividualFemale
Primary Taxonomy322D00000X
Provider Legal NameSTACEY LYNN JOHANSON
Location Address66 N 180 WEphraim, UT 84627-2130
Mailing Address66 N 180 WEphraim, UT 84627-2130 · (435) 283-0164
Phone(435) 283-0164
Sole ProprietorYes
Enumeration DateJanuary 13, 2022
NPPES CertifiedJanuary 13, 2022
✔ NPI 1194476895 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyResidential Treatment Facility, Emotionally Disturbed ChildrenResidential Treatment Facilities
Taxonomy Code322D00000X
Definition
A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.
66 N 180 W, Ephraim, UT 84627
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Other Providers at the Same Location NPPES 16

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RANAE REYNOLDS NEWLAND
Residential Treatment Facility, Emotionally Disturbed Children
66 N 180 W
EPHRAIM, UT 84627
Sanpete County (435) 283-0164
MCKAYLIE ANN PETERSON
Counselor
66 N 180 W
EPHRAIM, UT 84627
Sanpete County (435) 283-0164
CATHERINE ANN LEATHAM BACHELOR OF SCIENCE
Counselor (Mental Health)
66 N 180 W
EPHRAIM, UT 84627
Sanpete County (435) 283-0164
KIMBERLEY THORNBERRY
Counselor
66 N 180 W
EPHRAIM, UT 84627
Sanpete County (435) 283-0164
NICOLE ANN MERLETTE
Counselor
66 N 180 W
EPHRAIM, UT 84627
Sanpete County (435) 283-0164
BENJI FORBES
Counselor
66 N 180 W
EPHRAIM, UT 84627
Sanpete County (435) 283-0164
BRENNA SUE LUTHY
Substance Abuse Rehabilitation Facility (Substance Abuse Treatment, Children)
66 N 180 W
EPHRAIM, UT 84627
Sanpete County (435) 283-0164
CHERYL LUTHY
Community Health Worker
66 N 180 W
EPHRAIM, UT 84627
Sanpete County (435) 283-0164

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Stacey Johanson's NPI number?

The NPI number for Stacey Johanson is 1194476895. It was assigned to this individual provider in the NPPES registry on January 13, 2022.

Where is Stacey Johanson located?

Stacey Johanson practices at 66 N 180 W, Ephraim, UT 84627. The listed phone number is (435) 283-0164.

What is Stacey Johanson's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Emotionally Disturbed Children with taxonomy code 322D00000X.

When was this NPI record last updated?

The NPPES record for Stacey Johanson was last updated on January 13, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.