Individual provider Active NPI

Terrell Gayperail Johnson, LICSW

  • Clinical Social Worker
  • Brooklyn Park, MN
National Provider Identifier
1073382750
Registry record updated Jun 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
28040 Issued in MN
Practice address
8525 Edinbrook Xing Ste 211
Brooklyn Park, MN 55443-2060
Phone
(612) 567-2770
NPI assigned
Dec 22, 2023
Last updated
Jun 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 28040 MN Primary

Addresses

Primary practice location

8525 Edinbrook Xing Ste 211
Brooklyn Park, MN 55443-2060

Mailing address

PO Box 32227
Minneapolis, MN 55432-0227
Phone (612) 567-2770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240206000738 MN Practitioner - Clinical Social Worker 2860835949 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

440 Elm St E
Annandale, MN 55302-1109
Phone (320) 682-5225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Mar 9, 2024 Accepting new patients
Allina Health System Current Accepting new patients
Terrell Johnson LLC Clinical CurrentSince Dec 24, 2023 Accepting new patients
Allina Health System CurrentSince Mar 9, 2024 Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

8525 Edinbrook Xing
Ste 211
Brooklyn Park, MN 55443
Phone (612) 567-2770

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

825 Nicollet Mall
Ste 300
Minneapolis, MN 55402
Phone (612) 333-8883

Interoperability endpoints

  • Direct secure messaging: tjohnson139619@excellian.direct.allina.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1703203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782086400000",
    "number": "1073382750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 32227",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554320227",
            "telephone_number": "612-567-2770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8525 EDINBROOK XING STE 211",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554432060",
            "telephone_number": "612-567-2770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TERRELL",
        "middle_name": "GAYPERAIL",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-22",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "28040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn Park, MN

Sources for this page

Verify at the official NPI Registry.