Johnson, Katie
Johnson, Katie is an individual health care provider with primary practice located at 700 Twelve Oaks Center Dr Ste 208 , Wayzata MN 55391-4420. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Johnson, Katie can be contacted via phone (612) 324-8702.Contact Information
Primary practice address
700 Twelve Oaks Center Dr Ste 208
Wayzata MN 55391-4420
Phone: (612) 324-8702
Fax: (952) 209-1511
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Professional | 101YP2500X | 01929 | Minnesota |
Behavioral Health & Social Service Providers / Professional | 101YP2500X | 01595 | Minnesota |
Profile Details
NPI number | 1740678291 |
---|---|
LBN Legal business name | Johnson, Katie |
Credentials | MA, LPCC |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jan 7th, 2015 |
Last updated | Jan 3rd, 2020 - 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1740678291 | NPPES |
Minnesota | MEDICAID | 1740678291 |
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