Andrew A Johnson, BA BS MSW LICSW LADC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

26144 Issued in MN

Practice address

981 Glendon St N
Maplewood, MN 55119-3811

Phone

(612) 354-9027

NPI assigned

Feb 4, 2021

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Arts, Bachelor of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1612396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612396800000",
    "number": "1023600772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "981 GLENDON ST N",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551193811",
            "telephone_number": "612-354-9027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "981 GLENDON ST N",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551193811",
            "telephone_number": "612-354-9027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ANDREW",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "BA BS MSW LICSW LADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-04",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "304558",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "26144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Overboe Jarvis, DO
• Jensen & Jensen DDS PA
• Taleasha Jerde
• Fatuma Osman Jibrell
• Johnson Spine and Joint PLLC
• Bradley S Johnson, MD
• Christine Johnson
• Jennifer Joray Johnson
• Jodi Lynn Johnson, NP
• Julie A Johnson, CRNA

• Clinical Social Worker in Maplewood, MN
• Providers in Maplewood, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.