Individual provider Active NPI

Catherine A Johnson Dutcher, LPCC

  • Counselor
  • Fergus Falls, MN
National Provider Identifier
1083778773
Registry record updated Jan 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
519-12-15-04-163 Issued in ND
Practice address
980 S Tower Rd
Fergus Falls, MN 56537-5505
Phone
(218) 739-1725
Fax
(218) 736-6987
NPI assigned
Dec 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X 000079191 ND
Counselor 101Y00000X 519-12-15-04-163 ND Primary

Addresses

Primary practice location

980 S Tower Rd
Fergus Falls, MN 56537-5505

Mailing address

980 S Tower Rd
Fergus Falls, MN 56537-5505
Phone (218) 739-1725

Other names 1

  • Catherine A Johnson Professional name

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
I20240118003046 MN Practitioner - Mental Health Counselor 5597088856 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lakeland Mental Health Center IncGroup PAC ID 1759291891, 39 clinicians

Practice addresses (Care Compare)

1010 S 32ND Ave
Moorhead, MN 56560-5001
Phone (218) 233-7524

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1445MNMDRegistered Dietitian
000079191NDMDCase Manager/Care Coordinator

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Mental Health Center, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Lakeland Mental Health Center Case Manager/Care Coordinator PastSince Jan 1, 2024 Accepting new patients

Locations

980 S Tower Rd
Fergus Falls, MN 56537
Phone (218) 736-6987

1010 32nd Ave S
Moorhead, MN 56560
Phone (218) 233-7524

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485216000000",
    "number": "1083778773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 S TOWER RD",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565375505",
            "telephone_number": "218-739-1725",
            "fax_number": "218-736-6987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 S TOWER RD",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565375505",
            "telephone_number": "218-739-1725",
            "fax_number": "218-736-6987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON DUTCHER",
        "first_name": "CATHERINE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-20",
        "last_updated": "2017-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "ND",
            "license": "000079191",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "ND",
            "license": "519-12-15-04-163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CATHERINE",
            "last_name": "JOHNSON",
            "middle_name": "A",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Fergus Falls, MN

Sources for this page

Verify at the official NPI Registry.