Individual provider Active NPI

Zoe Chrysema Johnson, LPCC

  • Mental Health Counselor
  • Minneapolis, MN
National Provider Identifier
1629814132
Registry record updated Mar 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CC05414 Issued in MN
Practice address
4051 Sheridan Ave S
Minneapolis, MN 55410-1256
Phone
(612) 460-1131
NPI assigned
Jul 3, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CC05414 MN Primary

Addresses

Primary practice location

4051 Sheridan Ave S
Minneapolis, MN 55410-1256

Mailing address

4051 Sheridan Ave S
Minneapolis, MN 55410-1256

Other practice location 1

3115 Hennepin Ave
Minneapolis, MN 55408-2620
Phone (808) 640-9093

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CC05414MNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Inner Roadtrip CurrentSince Jul 7, 2024 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1719964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1629814132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4051 SHERIDAN AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554101256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4051 SHERIDAN AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554101256",
            "telephone_number": "612-460-1131"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3115 Hennepin Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554082620",
            "country_code": "US",
            "telephone_number": "808-640-9093",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ZOE",
        "middle_name": "CHRYSEMA",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-03",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC05414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2026; 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.