Individual provider Active NPI

Contessa Johnson, LPCC

  • Professional Counselor
  • Brooklyn Center, MN
National Provider Identifier
1164945200
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
1437 Issued in MN
Practice address
6040 Earle Brown Dr
Brooklyn Center, MN 55430-2514
Phone
(612) 860-8175
NPI assigned
Jul 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 1437 MN Primary

Addresses

Primary practice location

6040 Earle Brown Dr
Brooklyn Center, MN 55430-2514

Mailing address

6040 Earle Brown Dr
Brooklyn Center, MN 55430-2514

Other practice location 1

7401 Metro Blvd
Edina, MN 55439-3025
Phone (612) 860-8175

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1437MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cedar Hill Therapy, LLC Professional Past Accepting new patients

Organizations & group practices 1

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": "1500508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1164945200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6040 EARLE BROWN DR",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554302514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6040 EARLE BROWN DR",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554302514",
            "telephone_number": "612-860-8175"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7401 Metro Blvd",
            "address_purpose": "LOCATION",
            "city": "Edina",
            "state": "MN",
            "postal_code": "554393025",
            "country_code": "US",
            "telephone_number": "612-860-8175",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CONTESSA",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-20",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "1437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn Center, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.