MARISSA JOHNSON LICSW
NPI 1407725328
Social Worker in Roseau, MN

Q: 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.

Q: What is Marissa Johnson's specialty?

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

Q: 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 9 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.

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: August 02, 2026.

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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, and ordering and referring status from the CMS PECOS system.

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.

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