Johnson, Irene Teresa
Johnson, Irene Teresa is an individual health care provider with primary practice located at 2102 Elm Street N Fargo Va Hcs , Fargo ND 58102. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Johnson, Irene Teresa can be contacted via phone (701) 239-3700.Contact Information
Primary practice address
2102 Elm Street N Fargo Va Hcs
Fargo ND 58102
Phone: (701) 239-3700
Fax: (307) 745-8761
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | LCSW-374 | Wyoming |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 27855 | Minnesota |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 374 | Wyoming |
Profile Details
| NPI number | 1295733319 |
|---|---|
| LBN Legal business name | Johnson, Irene Teresa |
| Credentials | MSW, LCSW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 12th, 2005 |
| Last updated | Sep 14th, 2021 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1295733319 | NPPES |
| Wyoming | Other | 311123 | BS |
| Wyoming | Other | 800012487 | BS |
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