| Doctor Name: | MS. COLLEEN DEPUYDT JOHNSON |
| NPI Number: | 1376976787 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | SWP-LCSW-LIC-4574 |
| Business Practice Address: | 305 1st Ave. W Columbia Falls, MT - 59912 |
| Business Phone Number: | 4068924406 |
| Business Fax Number: | |
| Mailing Address: | 3536 Sunny Ln, COLUMBIA FALLS |
| State: | MT |
| Postal Code: | 599129043 |
| Phone Number: | 4062503845 |
| Fax Number: | |
| NPI Enumeration Date: | 08/21/2013 |
| NPI Last Update Date: | 08/21/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | SWP-LCSW-LIC-4574 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |