TIM JOHNSON M.S.W., LICSW & LMFT
NPI 1154310126
Marriage & Family Therapist in Lake Elmo, MN

Q: What is Tim Johnson's NPI number?

The NPI number for Tim Johnson is 1154310126. It was assigned to this individual provider in the NPPES registry on October 20, 2005.

Q: What is Tim Johnson's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Q: When was this NPI record last updated?

The NPPES record for Tim Johnson was last updated on December 23, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 20, 2005PECOS Enrolled

8669 EAGLE POINT BLVD, LAKE ELMO, MN 55042(651) 379-0444(651) 379-0448 Get Directions Write a Review

NPPES record last updated: December 23, 2011. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Tim Johnson M.s.w., Licsw & Lmft NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TIM JOHNSON M.S.W., LICSW & LMFT (NPI 1154310126) is an individual marriage & family therapist in Lake Elmo, Minnesota, licensed in Minnesota (157) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1154310126

Entity TypeIndividualMale

Primary Taxonomy106H00000X

Provider Legal NameTIM JOHNSONCredential: M.S.W., LICSW & LMFT

Location Address8669 EAGLE POINT BLVDLake Elmo, MN 55042-8628

Mailing Address8669 Eagle Point BlvdLake Elmo, MN 55042-8628 · (651) 379-0444 · Fax (651) 379-0448

Phone(651) 379-0444

Fax(651) 379-0448

Sole ProprietorNo

Enumeration DateOctober 20, 2005

Last NPPES UpdateDecember 23, 2011

✔ NPI 1154310126 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers

Taxonomy Code106H00000X

License✔ Licensed in MN · 157

Definition

A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X · License 409 (MN)

8669 EAGLE POINT BLVD, Lake Elmo, MN 55042

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Other Identifiers 8

OtherO95457000Magellan/aetna

Other69599MN · Value Options Id#

OtherHP45669MN · Health Partners Id#

Medicaid181557200MN

Other563T1JOMN · Bcbs Id#

Other247927MN · Compsych

Other102218Bhp/fairview Id#

Other62-13403MN · Medica/ubh Id#

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tim Johnson M.s.w., Licsw & Lmft is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

VICKI RAE NOVAK

Counselor (Professional)