Jean Nicole Johnson, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

31246 Issued in MN

Practice address

1210 5TH Ave
Worthington, MN 56187-2432

Phone

(507) 372-1515

Fax

(507) 376-4494

NPI assigned

Sep 3, 2025

Last updated

Sep 3, 2025By 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 1

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Southwestern Mental Health Center IncGroup PAC ID 7012816812, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Southwestern Mental Health Center Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Luverne, MN
  • NPI 1487654562
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1756857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1235019001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 175",
            "city": "WORTHINGTON",
            "state": "MN",
            "postal_code": "561870175",
            "telephone_number": "507-372-1515",
            "fax_number": "507-376-4494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 5TH AVE",
            "city": "WORTHINGTON",
            "state": "MN",
            "postal_code": "561872432",
            "telephone_number": "507-372-1515",
            "fax_number": "507-376-4494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JEAN",
        "middle_name": "NICOLE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-03",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "31246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Independent School District 518
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• Lindsay Jenniges, LICSW
• Johnson Eye Clinic, P.a
• Angela Marie Johnson, RDH
• Jerry Lee Johnson, D.D.S
• Roger Dean Johnson, O.D.
• Lezlie Pearl Jones, O.D.
• Theresa A Jones, OTR L
• Journeys of Healing, LLC

• Clinical Social Worker in Worthington, MN
• Providers in Worthington, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.