MATTHEW JOHANSEN MS LCPC QSUDP NPI 1487066320

NPI Information

  • NPI: 1487066320
  • Provider Name: MATTHEW JOHANSEN, MS, LCPC, QSUDP
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Individual
  • Address: 2131 S BONITO WAY
    MERIDIAN, ID
    ZIP 83642
  • Phone: (208) 202-4729

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NPI Details

Matthew Johansen, MS, LCPC, QSUDP is a mental health counselor in Meridian, ID. Matthew Johansen, MS, LCPC, QSUDP NPI is 1487066320. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2131 S BONITO WAY
MERIDIAN, ID
ZIP 83642-659
Phone: (208) 202-4729

The enumeration date for this NPI number is 5/27/2014 and was last updated on 2/22/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YM0800XCounselorMental HealthLCPC-6475IDAHOYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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