Beverly Jean Johnson, MA.LP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP2076 Issued in MN

Practice address

5275 Edina Industrial Blvd Ste 124
Edina, MN 55439-2903

Phone

(952) 926-3412

Fax

(952) 926-3414

NPI assigned

Sep 26, 2006

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565222400000",
    "number": "1295836492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5275 EDINA INDUSTRIAL BLVD STE 124",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554392903",
            "telephone_number": "952-926-3412",
            "fax_number": "952-926-3414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5275 EDINA INDUSTRIAL BLVD STE 124",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554392903",
            "telephone_number": "952-926-3412",
            "fax_number": "952-926-3414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BEVERLY",
        "middle_name": "JEAN",
        "credential": "MA.LP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2019-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP2076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rakesh John, MD
• Johnson Counseling Services LLC
• Andrew C Johnson-Cowley, CRNA
• Andrea Lynn Johnson, PSY.D.
• Angela Susan Johnson, NP-C
• Bradford V Johnson, MD
• Brent Lee Johnson
• Carly Kristin Martha Johnson, PA-C
• Christopher Adam Johnson, A.T.C.
• Craig R Johnson, LADC

• Psychologist in Edina, MN
• Providers in Edina, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2019; 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.