IndividualActive
Kimberlie Johnson
NPI 1104463694 · Clinical Social Worker · Provo, UT
Provider details
- NPI number
- 1104463694
- Entity type
- Individual
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Sex
- Female
- Sole proprietor
- Yes
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Established profile(58/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
83% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1881 N 1120 W
Provo, UT 84604-1180
Phone: (435) 248-2089
Fax: (801) 207-5104
Street-level locationGet directions
Mailing address
1881 N 1120 W
Provo, UT 84604-1180
Registry dates
- Enumerated
- 2019-12-04
- Last updated
- 2026-04-09
- Certified
- 2026-04-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.