John Robert Johnson, L.P.C.C.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CC00019 Issued in MN

Practice address

1920 College Way
Fergus Falls, MN 56537-1060

Phone

(701) 232-6224

Fax

(701) 232-4687

NPI assigned

Dec 12, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 8, 2024 through Apr 8, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Nystrom & Associates, LTD

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188
  NPD
• Valley Christian Counseling Center Inc

  • Professional Counselor
  • Fargo, ND
  • NPI 1467559427
  NPD

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

{
    "created_epoch": "1229040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1255576609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 NODAK DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581032333",
            "telephone_number": "701-232-6224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 COLLEGE WAY",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565371060",
            "telephone_number": "701-232-6224",
            "fax_number": "701-232-4687"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "305 30th Ave W",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "MN",
            "postal_code": "563083429",
            "country_code": "US",
            "telephone_number": "320-460-8028",
            "fax_number": "320-460-8029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JOHN",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "L.P.C.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-12",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "19",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC00019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Christine Johnson, MA, OTR/L
• Barbara L Johnson
• Debra Marlene Johnson, RN
• Diane Frances Johnson, LPN
• Jamie Lynn Johnson, LPN
• Kara Johnson
• Katie Nell Johnson, MCHC
• Lisa Kay Johnson
• Londa Susanne Johnson, RN
• Mackenzie Sue Johnson, LPN

• Professional Counselor in Fergus Falls, MN
• Providers in Fergus Falls, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.