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

Stacey Lynn Johanson

Individual provider Emotionally Disturbed Childrens' Residential Treatment Facility · NPI 1194476895

Stacey Lynn Johanson is an Emotionally Disturbed Childrens' Residential Treatment Facility in Ephraim, Utah. Practices as a sole proprietor. Registered with an NPI since 2022.

In the registry since
2022

Practice location Address checks out

66 N 180 W
Ephraim, UT 84627-2130
Phone: (435) 283-0164
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emotionally Disturbed Childrens' Residential Treatment Facility (primary) Taxonomy 322D00000X

Record details

NPI number1194476895
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJanuary 13, 2022
Last updated in NPPESJanuary 13, 2022
Certification dateJanuary 13, 2022
Mailing address66 N 180 W, Ephraim, UT 84627-2130

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