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MARISSA JOHNSON LICSW
NPI 1407725328
Social Worker in Roseau, MN

Active since October 30, 2025PECOS Enrolled
715 DELMORE DR, ROSEAU, MN 56751(218) 463-2500 Get Directions Write a Review

NPPES record last updated: October 30, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Marissa Johnson Licsw NPPES

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

MARISSA JOHNSON LICSW (NPI 1407725328) is an individual social worker in Roseau, Minnesota, licensed in Minnesota (31021) and active in the NPI registry since October 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1407725328
Entity TypeIndividualFemale
Primary Taxonomy104100000X
Provider Legal NameMARISSA JOHNSONCredential: LICSW
Location Address715 DELMORE DRRoseau, MN 56751-1599
Mailing Address715 Delmore DrRoseau, MN 56751-1599 · (218) 463-2500
Phone(218) 463-2500
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateOctober 30, 2025
NPPES CertifiedOctober 30, 2025
✔ NPI 1407725328 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers
Taxonomy Code104100000X
License✔ Licensed in MN · 31021
Definition
A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.
715 DELMORE DR, Roseau, MN 56751
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Marissa Johnson Licsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7113492646
PECOS Enrollment IDI20260413000124
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Marissa Johnson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Lifecare Medical Center
0.1 mi
Critical Access
715 DELMORE DR
Roseau, MN 56751
  • Reassigned Medicare billing, Minnesota enrollment
  • 89 clinicians in this Medicare group
NPI 1609861095 (218) 463-2500
North Homes, Inc.
153 mi
Community/Behavioral Health
413 SE 13TH ST
Grand Rapids, MN 55744
  • Reassigned Medicare billing, Minnesota enrollment
  • 22 clinicians in this Medicare group
NPI 1790826550 (218) 999-9908

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

LIFECARE MEDICAL CENTER
Home Health
715 DELMORE DR
ROSEAU, MN 56751
Roseau County (218) 463-2500
SAMANTHA JO OLSON CNP
Nurse Practitioner (Family)
715 DELMORE DR
ROSEAU, MN 56751
Roseau County (218) 463-2500
DANA LANDMAN
Social Worker (Clinical)
715 DELMORE DR
ROSEAU, MN 56751
Roseau County (218) 463-2500
DESSA MARIE BERGAN
Social Worker
715 DELMORE DR
ROSEAU, MN 56751
Roseau County (218) 463-2500
LAURA SALTZMAN MD
Emergency Medicine
715 DELMORE DR
ROSEAU, MN 56751
Roseau County (218) 463-2500
MRS. REKIYATU LAWAL UGBOAJAH MD
Emergency Medicine
715 DELMORE DR
ROSEAU, MN 56751
Roseau County (218) 463-2500
LIFECARE MEDICAL CENTER
Public Health or Welfare
715 DELMORE DR
ROSEAU, MN 56751
Roseau County (218) 463-2500
JENNIFER LYNN GALBRAITH MS, LMFT
Marriage & Family Therapist
715 DELMORE DR
ROSEAU, MN 56751
Roseau County (218) 463-4732

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Marissa Johnson's NPI number?

The NPI number for Marissa Johnson is 1407725328. It was assigned to this individual provider in the NPPES registry on October 30, 2025.

Where is Marissa Johnson located?

Marissa Johnson practices at 715 Delmore Dr, Roseau, MN 56751. The listed phone number is (218) 463-2500.

What is Marissa Johnson's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

Is Marissa Johnson enrolled in Medicare?

Yes. Marissa Johnson is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Marissa Johnson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Marissa Johnson reassigns Medicare benefits to 2 organizations: Lifecare Medical Center (Roseau, MN) and North Homes, Inc. (Grand Rapids, MN). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Marissa Johnson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Marissa Johnson was last updated on October 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.