Kathleen L Johnson, BS, LADC, CBIS

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

302203 Issued in MN

Practice address

10990 95TH St NE
Otsego, MN 55362-8149

Phone

(763) 329-7195

Fax

(952) 448-6047

NPI assigned

Jun 6, 2023

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 15, 2024.

{
    "created_epoch": "1686009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1346934072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 MARSCHALL RD STE 300",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553792690",
            "telephone_number": "952-856-3932",
            "fax_number": "952-448-6047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10990 95TH ST NE",
            "city": "OTSEGO",
            "state": "MN",
            "postal_code": "553628149",
            "telephone_number": "763-329-7195",
            "fax_number": "952-448-6047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KATHLEEN",
        "middle_name": "L",
        "credential": "BS, LADC, CBIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-06",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "302203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Integrity Independent Contracting, L.L.C.
• Kathryn M Isaacson, PA-C
• Kenzie Janson-Wolle, MSW, AASW
• Ashley Johnson, LICSW
• Jane Pollock Johnson
• Melanie Johnson
• Samantha M Johnson, DPT
• Angela Jones
• Kelsey Jorgensen
• K Sisters Home Care LLC

• All providers in Otsego, MN
• Addiction (Substance Use Disorder) Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; 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.