Pamela Johnson, MA, LMFT, LP

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

0736 Issued in MN

Practice address

1751 County Road B W Ste 100
Roseville, MN 55113-4037

Phone

(612) 719-5636

NPI assigned

Jul 19, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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 and National Provider Directory roles.

• Center for Integrated Well Being Inc

  • Clinical Social Worker
  • Saint Paul, MN
  • NPI 1053485003
  NPD (past)

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1235158940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4775 DODD RD",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551232112",
            "telephone_number": "612-719-5636",
            "fax_number": "651-846-4899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1751 COUNTY ROAD B W STE 100",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551134037",
            "telephone_number": "612-719-5636"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7066 Stillwater Blvd N",
            "address_purpose": "LOCATION",
            "city": "Oakdale",
            "state": "MN",
            "postal_code": "551283937",
            "country_code": "US",
            "telephone_number": "651-777-5222",
            "fax_number": "651-251-5111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "PAMELA",
        "credential": "MA, LMFT, LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "0541",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "0736",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH",
            "identifier": "62-20741",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "561853300",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UC",
            "identifier": "104309",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "P1",
            "identifier": "570038",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0G042JO",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HP",
            "identifier": "17621",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie Kay Johnson, PHARM.D.
• Keith W. Johnson, M.D.
• Kenton M Johnson, DDS MS
• Lisa J Johnson
• Mark Robert Johnson, D.C.
• Summer Johnson
• Sean K Johnston, M.D.
• Joining Hands Child and Family Counseling Services, LLC
• Caroline Jolstad
• Cassidy Jones, CRNA

• Marriage & Family Therapist in Roseville, MN
• Providers in Roseville, MN by specialty
• Marriage & Family Therapist in Minnesota

• 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.