Catherine Rose Johanneck, M.S.W. L.I.C.S.W

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

17989 Issued in MN

Practice address

7362 University Ave NE Ste 101
Fridley, MN 55432-3152

Phone

(763) 503-3981

Fax

(763) 503-3981

NPI assigned

Jan 19, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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, 2009

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

DBT AssociatesGroup PAC ID 6800889577, 6 clinicians

Practice addresses (Care Compare)

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.

• DBT Associates

  • Mental Health Counselor
  • Fridley, MN
  • NPI 1639104193

  Clinical

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1326931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525305600000",
    "number": "1932470127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7362 UNIVERSITY AVE NE STE 101",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554323152",
            "telephone_number": "763-503-3981",
            "fax_number": "763-503-3981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7362 UNIVERSITY AVE NE STE 101",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554323152",
            "telephone_number": "763-503-3981",
            "fax_number": "763-503-3981"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 N Cedar Ave",
            "address_purpose": "LOCATION",
            "city": "Owatonna",
            "state": "MN",
            "postal_code": "550602307",
            "country_code": "US",
            "telephone_number": "507-451-3282 x203",
            "fax_number": "507-451-3287",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHANNECK",
        "first_name": "CATHERINE",
        "middle_name": "ROSE",
        "credential": "M.S.W. L.I.C.S.W",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-19",
        "last_updated": "2018-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "17989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH-UBH",
            "identifier": "1932470127",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1932470127",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCC",
            "identifier": "1932470127",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jannah Health Services, LLC
• Jasira Family Counseling
• Camille Jensen, MA, LPCC, LADC
• Abdulhamid Hassan Jibrell
• Sundus Hussein Jibrill
• Paula Jean Johns, RN
• Amber M Johnson, PA
• Ann Serbus Johnson, PT
• Daniel Johnson
• Donald Edward Johnson, M.D.

• Clinical Social Worker in Fridley, MN
• Providers in Fridley, 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 May 3, 2018; 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.