Heather J Johnson, PSYD

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

5388 Issued in MN

Practice address

4601 Excelsior Blvd Ste 411
St Louis Park, MN 55416-4977

Phone

(612) 294-9458

NPI assigned

Jun 7, 2010

Last updated

Feb 11, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Heather Johnson LLC

  • Counseling Psychologist
  • St Louis Park, MN
  • NPI 1750742300
  NPD (past) Authorized official

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

{
    "created_epoch": "1275868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549843200000",
    "number": "1053631622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 EXCELSIOR BLVD STE 411",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554164977",
            "telephone_number": "612-294-9458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 EXCELSIOR BLVD STE 411",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554164977",
            "telephone_number": "612-294-9458"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15251 Pleasant Valley Rd",
            "address_purpose": "LOCATION",
            "city": "Center City",
            "state": "MN",
            "postal_code": "550129640",
            "country_code": "US",
            "telephone_number": "651-213-4286",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "HEATHER",
        "middle_name": "J",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-07",
        "last_updated": "2019-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MN",
            "license": "5388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "174658000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anna Lynn Johnson, APRN CNP
• Blake A Johnson, MD
• Christopher Johnson, MD
• Elizabeth M Johnson, OD
• Elliot Mohr Johnson, MD
• Jeffrey Randall Johnson, MD
• Jennifer Yun Johnson, LIC. AC., MAOM
• Jodie Johnson
• Julia Anne Johnson, P.T.
• Kaisa L Johnson, C.N.M.

• Counseling Psychologist in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• Counseling Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2019; 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.