Johnson, Jaclyn Rachel

Johnson, Jaclyn Rachel is an individual health care provider with primary practice located at 4100 Berkshire Ln N , Plymouth MN 55446-3813. 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 / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Johnson, Jaclyn Rachel can be contacted via phone (763) 203-9568.

Contact Information

Primary practice address
4100 Berkshire Ln N Plymouth MN 55446-3813
Phone: (763) 203-9568
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 306063 Minnesota
Behavioral Health & Social Service Providers / Professional 101YP2500X CC04220 Minnesota

Profile Details

NPI number 1447912316
LBN Legal business name Johnson, Jaclyn Rachel
Credentials MA, LPCC, LADC
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 8th, 2021
Last updated Feb 1st, 2024 - about last year

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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