Life Course Therapy

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

LIFE COURSE THERAPY

Doing business as

Annie Johnson Sirek

Practice address

2212 32ND Ave S
Minneapolis, MN 55406-1425

Phone

(165) 132-5735

NPI assigned

Jul 30, 2021

Organization subpart

No

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

Authorized official

Name

Ann Catherine Johnson, LICSWNPI 1821761230

Title

Mental Health Professional

Phone

(651) 325-7355

Specialties & licenses 1

Addresses

Other names 1

• Annie Johnson Sirek Doing business as

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ann Catherine Johnson, LICSW

  • Clinical Social Worker
  • Minneapolis, MN
  • NPI 1821761230
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1627603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627603200000",
    "number": "1427721778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2212 32ND AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554061425",
            "telephone_number": "165-132-5735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2212 32ND AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554061425",
            "telephone_number": "165-132-5735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE COURSE THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-30",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-30",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "ANN",
        "authorized_official_middle_name": "CATHERINE",
        "authorized_official_title_or_position": "MENTAL HEALTH PROFESSIONAL",
        "authorized_official_telephone_number": "651-325-7355",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Annie Johnson Sirek",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tara Lien
• Brian Lieser
• Elizabeth Anne Lieske, MD
• Life Care Health Services LLC (life care health service)
• Life Care Health Services LLC
• Life Matters PLC (Life Matters Counseling)
• Life Refine Company, Inc.
• Life Services Group, LLC
• Lifeforce Chiropractic PA
• Lifeforce Services Inc

• Adult Mental Health Clinic/Center in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Adult Mental Health Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.