Ann Catherine Johnson, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

23298 Issued in MN

Practice address

2212 32ND Ave S
Minneapolis, MN 55406-1425

Phone

(165) 132-5735

NPI assigned

Jul 30, 2021

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

Other names 1

• Annie Johnson Sirek Other name

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

Clinical Social Worker

Education

Other, 2011

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Life Course Therapy

  • Adult Mental Health Clinic/Center
  • Minneapolis, MN
  • NPI 1427721778
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1627603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627603200000",
    "number": "1821761230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2212 32ND AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554061425",
            "telephone_number": "165-132-5735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2212 32ND AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554061425",
            "telephone_number": "165-132-5735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ANN",
        "middle_name": "CATHERINE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-30",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "23298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNIE",
            "last_name": "SIREK",
            "middle_name": "JOHNSON",
            "credential": "LICSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Andrea Mary Johnson, MD
• Andrew David Johnson, M.D.
• Angelica Johnson
• Anita Patricia Johnson
• Anjali Johnson
• Anna Johnson, DO
• Anne Marie Johnson, PT
• Annette Johnson
• Arielle Johnson, MSW, LICSW
• Ashley Johnson, OT

• Clinical Social Worker in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2021; 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.