Provider Demographics
NPI:1912701426
Name:JOHANSON, SARAH A (LCSW)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:A
Last Name:JOHANSON
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4324 MAPLESHADE LN STE 248
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-0050
Mailing Address - Country:US
Mailing Address - Phone:214-494-1314
Mailing Address - Fax:
Practice Address - Street 1:4324 MAPLESHADE LN STE 248
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-0050
Practice Address - Country:US
Practice Address - Phone:214-494-1314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1086181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical