Johanneck, Catherine Rose

Johanneck, Catherine Rose is an individual health care provider with primary practice located at 7362 University Ave Ne Ste 101 , Fridley MN 55432-3152. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Johanneck, Catherine Rose can be contacted via phone (763) 503-3981.

Contact Information

Primary practice address
7362 University Ave Ne Ste 101 Fridley MN 55432-3152
Phone: (763) 503-3981
Fax: (763) 503-3981
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 17989 Minnesota

Profile Details

NPI number 1932470127
LBN Legal business name Johanneck, Catherine Rose
Credentials M.S.W. L.I.C.S.W
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 19th, 2012
Last updated May 3rd, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932470127 NPPES
Minnesota Other 1932470127 CAQH-UBH
Minnesota MEDICAID 1932470127 CAQH-UBH
Minnesota Other 1932470127 CAQH-UBH

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