Johnson, Heather J

Johnson, Heather J is an individual health care provider with primary practice located at 4601 Excelsior Blvd Ste 411 , St Louis Park MN 55416-4977. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Counseling. Behavioral Health & Social Service Providers / Counseling is her primary health care specialty. Johnson, Heather J can be contacted via phone (612) 294-9458.

Contact Information

Primary practice address
4601 Excelsior Blvd Ste 411 St Louis Park MN 55416-4977
Phone: (612) 294-9458
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 103TA0400X
Behavioral Health & Social Service Providers / Counseling 103TC1900X 5388 Minnesota

Profile Details

NPI number 1053631622
LBN Legal business name Johnson, Heather J
Credentials PSYD
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 7th, 2010
Last updated Feb 11th, 2019 - about 5 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 1053631622 NPPES
Minnesota MEDICAID 174658000

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