Alisa R Johnson, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

3612 Issued in MN

Practice address

217 Industrial Dr SW
Willmar, MN 56201-2989

Phone

(320) 295-3450

NPI assigned

Dec 5, 2022

Sex

Female

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

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

Specialty

Mental Health Counselor

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ametrine Mental Health PLLCGroup PAC ID 4385009943, 5 clinicians

Community Outreach Counseling PCGroup PAC ID 1557581543, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Ametrine Mental Health PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Spicer, MN
  • NPI 1902526437
  Medicare reassignment Care Compare group NPD
• Community Outreach Counseling PC

  • Community/Behavioral Health Agency
  • Willmar, MN
  • NPI 1245673482
  Medicare reassignment Care Compare group NPD
• Mental Health Specialty Group PA

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  MN, Professional

  Medicare reassignment NPD
• Peterson Wellness Clinic P.a.

  • Chiropractor
  • Spicer, MN
  • NPI 1639791932
  NPD

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

{
    "created_epoch": "1670198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1598475212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12706 COUNTY ROAD 27 NW",
            "city": "PENNOCK",
            "state": "MN",
            "postal_code": "562798510",
            "telephone_number": "320-295-3450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 INDUSTRIAL DR SW",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562012989",
            "telephone_number": "320-295-3450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ALISA",
        "middle_name": "R",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-05",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "3612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Jo Johanneck, APRN, AGNP, CNP
• Cassandra Mary Johansen, LPCC
• Isabelle Johansen
• Elgin Bruce Johns Jr., SPN PHYSICIAN EXTEND
• Alan Ralph Johnson, LICSW LMFT
• Amber Erin Johnson, WHNP
• Andrew Robert Johnson, LMFT
• Hannah Johnson
• Heather L Johnson, PHARMD
• Jaclyn A Johnson, RD

• Professional Counselor in Willmar, MN
• Providers in Willmar, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.