Kelly Johnson, LAMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

3885 Issued in MN

Practice address

5666 Lincoln Dr Ste 210
Edina, MN 55436-1671

Phone

(612) 552-2132

NPI assigned

Sep 15, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Family Support Services Inc.

  • Mental Health Counselor
  • New Brighton, MN
  • NPI 1467549220

  Single Specialty

  NPD (past)
• Nystrom & Associates, LTD

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188

  Marriage & Family Therapist

  NPD (past)

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

{
    "created_epoch": "1631664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636761600000",
    "number": "1821768466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5666 LINCOLN DR STE 210",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554361671",
            "telephone_number": "612-552-2132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5666 LINCOLN DR STE 210",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554361671",
            "telephone_number": "612-552-2132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KELLY",
        "credential": "LAMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-15",
        "last_updated": "2021-11-13",
        "certification_date": "2021-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "3885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ian Mark Johnson, PA-C
• Jay S Johnson, M.D.
• Jill M Johnson, M.D.
• Jordan David Johnson, PA
• Keith Emmett Johnson, DDS
• Kimberly K Johnson
• Linda C Johnson, M.D.
• Lisa Dawn Johnson, RN
• Madeline K Johnson, PA-C
• Mary Alycia Johnson

• Marriage & Family Therapist in Edina, MN
• Providers in Edina, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2021; 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.