Tiffany Irene Johnson, MSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

21005 Issued in MN

Practice address

9220 Bass Lake Rd Ste 255
New Hope, MN 55428-3019

Phone

(763) 252-4502

Fax

(888) 965-5130

NPI assigned

Feb 23, 2016

Last updated

Dec 23, 2025By the provider in NPPES

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

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Volunteers of America MN/Wi

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New Hope, MN
  • NPI 1093769572
  Medicare reassignment NPD
• Volunteers of America MN/Wi

  dba Volunteers of America of Minnesota Mental Health Clinics

  • Community/Behavioral Health Agency
  • New Hope, MN
  • NPI 1548436090
  NPD

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

{
    "created_epoch": "1456185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766448000000",
    "number": "1982063657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7625 METRO BLVD STE 200",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554393079",
            "telephone_number": "763-225-4052",
            "fax_number": "888-965-5130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9220 BASS LAKE RD STE 255",
            "city": "NEW HOPE",
            "state": "MN",
            "postal_code": "554283019",
            "telephone_number": "763-252-4502",
            "fax_number": "888-965-5130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TIFFANY",
        "middle_name": "IRENE",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-23",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "21005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Camille Jarombek, LMFT
• Jason W. Phillips, D.C., P.a.
• JBM Individual & Family Counseling LLC
• Kristin L Johnson, D.C.
• Sheridan Johnson, M.A.
• Bianca N Junior
• Amanda Kaiser, MA LMFT
• Steve Michael Kelley, RN
• Kristen Kellogg, OTR/L
• Kristen Kerkhoff, LICSW

• Clinical Social Worker in New Hope, MN
• Providers in New Hope, 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 Dec 23, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.