Individual provider Active NPI

Lindsey Kaye Johnson, LMFT

  • Marriage & Family Therapist
  • Eagan, MN
National Provider Identifier
1689812299
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2245 Issued in MN
Practice address
4660 Slater Rd Ste 120
Eagan, MN 55122-4048
Phone
(612) 276-2462
Fax
(612) 246-3682
NPI assigned
Feb 4, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Marriage & Family Therapist 106H00000X 124387 IA
Marriage & Family Therapist 106H00000X 2245 MN Primary

Addresses

Primary practice location

4660 Slater Rd Ste 120
Eagan, MN 55122-4048

Mailing address

4660 Slater Rd Ste 120
Eagan, MN 55122-4048
Phone (612) 276-2462

Other names 1

  • Lindsey Kaye Peters Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Feb 13, 2024 through Feb 13, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
124387IAMDMarriage & Family Therapist
2245MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Panoramic Perspectives Therapy and Training, PA PastSince Jan 26, 2022 Accepting new patients
Family Innovations, Inc. Marriage & Family Therapist PastSince May 7, 2020 Accepting new patients
Ellie Family Services, PLLP PastSince Jan 1, 2022 Accepting new patients

Organizations & group practices 3

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": "1233705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1689812299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4660 SLATER RD STE 120",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551224048",
            "telephone_number": "612-276-2462",
            "fax_number": "612-246-3682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 SLATER RD STE 120",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551224048",
            "telephone_number": "612-276-2462",
            "fax_number": "612-246-3682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LINDSEY",
        "middle_name": "KAYE",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-04",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IA",
            "license": "124387",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDSEY",
            "last_name": "PETERS",
            "middle_name": "KAYE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Eagan, MN

Sources for this page

Verify at the official NPI Registry.