Johnson, Kenneth

Johnson, Kenneth is an sole proprietor health care provider with primary practice located at 3570 Lexington Ave N , Shoreview MN 55126-8049. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Johnson, Kenneth can be contacted via phone (651) 481-0664.

Contact Information

Primary practice address
3570 Lexington Ave N Shoreview MN 55126-8049
Fax: (651) 481-3907
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 495 Minnesota

Profile Details

NPI number 1578625893
LBN Legal business name Johnson, Kenneth
Credentials LICSW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 14th, 2006
Last updated Jul 8th, 2007 - about 19 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 1578625893 NPPES
Minnesota Other HP34166 HEALTH PARTNERS

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