Individual provider Active NPI

Katie Lyn Jensen Johnson, MA, LMFT

  • Marriage & Family Therapist
  • Brooklyn Park, MN
National Provider Identifier
1912372632
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
3139 Issued in MN
Practice address
9400 Zane Ave N
Brooklyn Park, MN 55443-1814
Phone
(763) 762-8813
Fax
(763) 315-3539
NPI assigned
Dec 7, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 3139 MN Primary

Addresses

Primary practice location

9400 Zane Ave N
Brooklyn Park, MN 55443-1814

Mailing address

9400 Zane Ave N
Brooklyn Park, MN 55443-1814
Phone (763) 762-8813

Other names 1

  • Katie Lyn Jensen Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1449446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1912372632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9400 ZANE AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554431814",
            "telephone_number": "763-762-8813",
            "fax_number": "763-315-3539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9400 ZANE AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554431814",
            "telephone_number": "763-762-8813",
            "fax_number": "763-315-3539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KATIE",
        "middle_name": "LYN JENSEN",
        "credential": "MA, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-07",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "3139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "JENSEN",
            "middle_name": "LYN",
            "credential": "MA, LMFT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brooklyn Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; 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.