Individual provider Active NPI

Elizabeth Johnson, LGSW

  • Clinical Social Worker
  • Saint Paul, MN
National Provider Identifier
1487310546
Registry record updated Nov 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
23625 Issued in MN
Practice address
1142 Lafond Ave
Saint Paul, MN 55104-2028
Phone
(612) 888-9065
NPI assigned
Nov 12, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 23625 MN Primary

Addresses

Primary practice location

1142 Lafond Ave
Saint Paul, MN 55104-2028

Mailing address

1142 Lafond Ave
Saint Paul, MN 55104-2028
Phone (612) 888-9065

Other practice location 1

1611 County Road B W Ste 102
Roseville, MN 55113-4053
Phone (612) 888-9065

Other names 1

  • Libby Johnson Other name

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
I20260402000297 MN Practitioner - Clinical Social Worker 9931684412 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

503 Sterling St S
Maplewood, MN 55119-5579

7203 Perry CT E
Minneapolis, MN 55429-1202

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23625MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ainga Mental Health and Consulting LLC Clinical Past Accepting new patients

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": "1636675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1487310546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1142 LAFOND AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551042028",
            "telephone_number": "612-888-9065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1142 LAFOND AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551042028",
            "telephone_number": "612-888-9065"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1611 County Road B W Ste 102",
            "address_purpose": "LOCATION",
            "city": "Roseville",
            "state": "MN",
            "postal_code": "551134053",
            "country_code": "US",
            "telephone_number": "612-888-9065",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ELIZABETH",
        "credential": "LGSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-12",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "23625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LIBBY",
            "last_name": "JOHNSON",
            "credential": "LGSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.