Individual provider Active NPI

Kristen Sue Johnson, RN, LMFT

  • Marriage & Family Therapist
  • Saint Paul, MN
National Provider Identifier
1306105606
Registry record updated May 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2085 Issued in MN
Practice address
1449 Cleveland Ave N
Saint Paul, MN 55108-1413
Phone
(651) 645-5323
Fax
(651) 328-8254
NPI assigned
May 8, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 2085 MN Primary

Addresses

Primary practice location

1449 Cleveland Ave N
Saint Paul, MN 55108-1413

Mailing address

1449 Cleveland Ave N
Saint Paul, MN 55108-1413
Phone (651) 645-5323

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240401001723 MN Practitioner - Marriage and Family Therapist 9133567852 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emily Program P CGroup PAC ID 5193623254, 49 clinicians

Practice addresses (Care Compare)

2230 Como Ave
Saint Paul, MN 55108-1720
Phone (651) 645-5323

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
2085MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Emily Program P C CurrentSince Feb 17, 2024 Accepting new patients

Locations

2265 Como Ave
Saint Paul, MN 55108

2230 Como Ave
Saint Paul, MN 55108
Phone (651) 635-0095

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1336435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336435200000",
    "number": "1306105606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1449 CLEVELAND AVE N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551081413",
            "telephone_number": "651-645-5323",
            "fax_number": "651-328-8254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1449 CLEVELAND AVE N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551081413",
            "telephone_number": "651-645-5323",
            "fax_number": "651-328-8254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KRISTEN",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "RN, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-08",
        "last_updated": "2012-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.