Heather Johnson LLC

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

5388 Issued in MN

Legal business name

HEATHER JOHNSON LLC

Practice address

4601 Excelsior Blvd Ste 411
St Louis Park, MN 55416-4977

Phone

(612) 294-9458

NPI assigned

Mar 10, 2016

Last updated

Sep 6, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Heather J Johnson, PSYDNPI 1053631622

Title

Licensed Psychologist

Phone

(612) 294-9458

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Heather J Johnson, PSYD

  • Counseling Psychologist
  • St Louis Park, MN
  • NPI 1053631622
  NPD (past) Authorized official

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

{
    "created_epoch": "1457568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1750742300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 EXCELSIOR BLVD STE 411",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554164977",
            "telephone_number": "612-294-9458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 EXCELSIOR BLVD STE 411",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554164977",
            "telephone_number": "612-294-9458"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2908 Humboldt Ave S",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554081953",
            "country_code": "US",
            "telephone_number": "612-294-9458",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HEATHER JOHNSON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-10",
        "last_updated": "2023-09-06",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "612-294-9458",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Counseling",
            "state": "MN",
            "license": "5388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Counseling Psychologist in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• Counseling Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.