Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Rudy Johansen, LCSW

Individual provider Clinical Social Worker · NPI 1255382610

Rudy Johansen, LCSW is a Clinical Social Worker in Salt Lake City, Utah. Licensed in Utah. Registered with an NPI since 2006.

Licensed in
UT
In the registry since
2006
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

500 Foothill Dr 116HO
Salt Lake City, UT 84148-0001
Phone: (801) 582-1565
Fax: (801) 584-2507
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 134481-3501 (UT)

Record details

NPI number1255382610
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorNo
NPI enumeratedMay 12, 2006
Last updated in NPPESJuly 13, 2026

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