Bradley D Johnson, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

1209 Issued in MN

Practice address

15798 Venture LN
Suite 201
Eden Prairie, MN 55344-5729

Phone

(952) 746-3883

Fax

(952) 746-3894

NPI assigned

Apr 10, 2007

Sex

Male

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": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417170374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15798 VENTURE LN",
            "address_2": "SUITE 201",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445729",
            "telephone_number": "952-746-3883",
            "fax_number": "952-746-3894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15798 VENTURE LN",
            "address_2": "SUITE 201",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445729",
            "telephone_number": "952-746-3883",
            "fax_number": "952-746-3894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRADLEY",
        "middle_name": "D",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "1209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hodan Hassan Jimale
• Jmi Recuperative Care LLC
• Bo Johannes, RN
• Amanda Lee Johnson Fleming, CPNP-PC
• Abby Johnson, LAT
• Byron W Johnson, M.D.
• Chandler Johnson
• Heather Kathryn Johnson, CMT
• Holly Johnson
• Katherine Teresa Johnson, M.A., L.P.

• Marriage & Family Therapist in Eden Prairie, MN
• Providers in Eden Prairie, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.