Lacie Leeann Johnson, LICSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

17988 Issued in MN

Practice address

1811 Weir Dr
Woodbury, MN 55125-2272

Phone

(651) 714-9646

NPI assigned

Jan 13, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Family Support Services Inc.

  • Mental Health Counselor
  • New Brighton, MN
  • NPI 1467549220
  NPD
• Nest Professional Service Corp

  • Community/Behavioral Health Agency
  • Stillwater, MN
  • NPI 1508314071
  NPD (past)

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

{
    "created_epoch": "1263340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517875200000",
    "number": "1578893517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 WEIR DR STE 270",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551256741",
            "telephone_number": "651-379-1718",
            "fax_number": "651-714-9647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 WEIR DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252272",
            "telephone_number": "651-714-9646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LACIE",
        "middle_name": "LEEANN",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-13",
        "last_updated": "2018-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": "17988",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "17988",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justyna Johnson, DNP
• Karen Louise Johnson, OTRL
• Karyn L Johnson, MD
• Kayla Junaye Johnson
• Krystal Johnson, LGSW
• Maryann S Johnson, PT
• Melissa Louise Johnson, LMFT
• Michael Randall Johnson, MD
• Miriah J Johnson, DPT
• Rachel Valerie Johnson, PA-C

• Social Worker in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2018; 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.