Joanna Lynn Johnson, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

15968 Issued in MN

Practice address

4826 Chicago Ave Ste 105
Minneapolis, MN 55417-1055

Phone

(612) 827-3028

NPI assigned

Sep 21, 2019

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

Other identifiers 2

Electronic endpoints 1

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

Clinical Social Worker

Education

Other, 2012

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Centerlife Counseling, LLC

  • Mental Health Counselor
  • Centerville, MN
  • NPI 1417283946

  Clinical

  Medicare reassignment NPD
• Fairview Express Care

  dba M Health Fairview Recovery Clinic

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1053952606
  Medicare reassignment
• Center for Child Abuse Prevention and Treatment

  dba Family Enhancement Center

  • Community/Behavioral Health Agency
  • Minneapolis, MN
  • NPI 1427228709
  NPD (past)

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

{
    "created_epoch": "1569024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593734400000",
    "number": "1255982211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4826 CHICAGO AVE STE 105",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554171055",
            "telephone_number": "612-827-3028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4826 CHICAGO AVE STE 105",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554171055",
            "telephone_number": "612-827-3028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JOANNA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-21",
        "last_updated": "2020-07-03",
        "certification_date": "2020-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "15968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL INSURANCES",
            "identifier": "15968",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "15968",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "office",
            "affiliation": "N",
            "endpointDescription": "office",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "office",
            "address_1": "4826 Chicago Ave Ste 105",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554171055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jennifer Susan Johnson, CRNA
• Jeremiah Joseph Johnson, MD
• Jessica Joy Johnson, CD
• Jill B Johnson, MD
• Joann E Johnson, MD
• Judy Bergstrom Johnson, OT
• Julia Pearl Johnson, DPT
• Karen Ann Johnson, LADC
• Karen Lynn Johnson, DO
• Katarina Helen Johnson, APRN, CNP

• Clinical Social Worker in Minneapolis, MN
• Providers in Minneapolis, 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 Jul 3, 2020; 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.