Jennifer Marie Johnson, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

909 Issued in MN

Practice address

11280 86TH Ave N
Maple Grove, MN 55369-4510

Phone

(763) 400-7828

NPI assigned

Dec 9, 2014

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

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.

• Healthwise Psychology, PA

  • Clinical Psychologist
  • Maple Grove, MN
  • NPI 1184920753
  Medicare reassignment NPD
• Scott M Yarosh, LLC

  • Mental Health Counselor
  • Saint Paul, MN
  • NPI 1144543265
  NPD

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

{
    "created_epoch": "1418083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1790183614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 FRANCE AVE S",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554351805",
            "telephone_number": "952-835-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11280 86TH AVE N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694510",
            "telephone_number": "763-400-7828"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6600 France Ave S",
            "address_purpose": "LOCATION",
            "city": "Edina",
            "state": "MN",
            "postal_code": "554351805",
            "country_code": "US",
            "telephone_number": "952-835-2002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-09",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Nicole Breuer Johnson, LPCC
• Geniyah Johnson
• Grace Johnson, LICSW
• Janell Ruth Johnson
• Jean Johnson
• Jewel Johnson
• Karen Marie Johnson, PT
• Keith Johnson, MD
• Keith Michael Johnson, DC
• Kyrsten Ann Johnson, M.D.

• Mental Health Counselor in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.