Johnson, Tim

Johnson, Tim is an individual health care provider with primary practice located at 8669 Eagle Point Blvd , Lake Elmo MN 55042-8628. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Marriage & Family Therapist is his primary health care specialty. Johnson, Tim can be contacted via phone (651) 379-0444.

Contact Information

Primary practice address
8669 Eagle Point Blvd Lake Elmo MN 55042-8628
Phone: (651) 379-0444
Fax: (651) 379-0448
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 409 Minnesota
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 157 Minnesota

Profile Details

NPI number 1154310126
LBN Legal business name Johnson, Tim
Credentials M.S.W., LICSW & LMFT
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 20th, 2005
Last updated Dec 23rd, 2011 - about 13 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 1154310126 NPPES
Minnesota Other 563T1JO BCBS ID#
Minnesota Other 62-13403 BCBS ID#
Minnesota Other 247927 BCBS ID#
Minnesota Other O95457000 BCBS ID#
Minnesota MEDICAID 181557200 BCBS ID#
Minnesota Other 69599 BCBS ID#
Minnesota Other 102218 BCBS ID#
Minnesota Other HP45669 BCBS ID#

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