Jessica Johnson, MA, LPCC

Individual provider Active NPI Professional Counselor · Ham Lake, MN

NPI 1134070139 · NPPES record last updated Feb 5, 2026

Key facts

NPI
1134070139
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
5415 (MN)
Practice address
18015 Ulysses St NE Ste 400
Ham Lake, MN 55304-4896
Phone
(763) 447-8598
NPI assigned
Feb 5, 2026
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
5415MNMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 5415 MN Yes

Addresses

Primary practice location

18015 Ulysses St NE Ste 400
Ham Lake, MN 55304-4896

Mailing address

14512 Jonquil St NW
Andover, MN 55304-3261
Phone (763) 447-8598

Other providers in Ham Lake, MN

All providers in Ham Lake, MN · Professional Counselor in Minnesota

Sources for this page

Verify at the official NPI Registry.