Individual provider Active NPI

Kristin Johnson, MA, LMFT

  • Marriage & Family Therapist
  • Chaska, MN
National Provider Identifier
1912375387
Registry record updated Jul 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2281 Issued in MN
Practice address
562 Bavaria LN
Chaska, MN 55318
Phone
(612) 250-7862
NPI assigned
Sep 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2019

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 2281 MN Primary

Addresses

Primary practice location

562 Bavaria LN
Chaska, MN 55318

Mailing address

562 Bavaria LN
Chaska, MN 55318-4597
Phone (612) 250-7862

Other practice location 1

510 N Chestnut St Ste 201
Chaska, MN 55318-3316
Phone (952) 361-3360

Other practice location 2

510 N Chestnut St Ste 201
Chaska, MN 55318-3316
Phone (952) 361-3360

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20241211003266 MN Practitioner - Marriage and Family Therapist 6800322009 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

562 Bavaria LN
Chaska, MN 55318-4597
Phone (612) 250-7862

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
2281MNMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Grows PLLC Marriage & Family Therapist CurrentSince Oct 15, 2024 Accepting new patients

Locations

562 Bavaria Ln
Chaska, MN 55318
Phone (612) 236-6799

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1441152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563753600000",
    "number": "1912375387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "562 BAVARIA LN",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553184597",
            "telephone_number": "612-250-7862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "562 BAVARIA LN",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "55318",
            "telephone_number": "612-250-7862"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "510 N Chestnut St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Chaska",
            "state": "MN",
            "postal_code": "553183316",
            "country_code": "US",
            "telephone_number": "952-361-3360",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "510 N Chestnut St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Chaska",
            "state": "MN",
            "postal_code": "553183316",
            "country_code": "US",
            "telephone_number": "952-361-3360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KRISTIN",
        "name_prefix": "Mrs.",
        "credential": "MA, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-02",
        "last_updated": "2019-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chaska, MN

Sources for this page

Verify at the official NPI Registry.