Johnson, Pamela

Johnson, Pamela is an individual health care provider with primary practice located at 1751 County Road B W Ste 100 , Roseville MN 55113-4037. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Marriage & Family Therapist is her primary health care specialty. Johnson, Pamela can be contacted via phone (612) 719-5636.

Contact Information

Primary practice address
1751 County Road B W Ste 100 Roseville MN 55113-4037
Phone: (612) 719-5636
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 0541 Minnesota
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 0736 Minnesota

Profile Details

NPI number 1235158940
LBN Legal business name Johnson, Pamela
Credentials MA, LMFT, LP
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2006
Last updated Mar 17th, 2018 - about 8 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 1235158940 NPPES
Minnesota Other 62-20741 UBH
Minnesota MEDICAID 561853300 UBH
Minnesota Other 104309 UBH
Minnesota Other 570038 UBH
Minnesota Other 0G042JO UBH
Minnesota Other 17621 UBH

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