SAMANTHA ANN PRUITT-JOHNSON
NPI 1750987749
Counselor - Mental Health in St Louis Park, MN

Q: What is Samantha Pruitt-johnson's NPI number?

The NPI number for Samantha Pruitt-johnson is 1750987749. It was assigned to this individual provider in the NPPES registry on December 7, 2020.

Q: What is Samantha Pruitt-johnson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Active since December 07, 2020PECOS Enrolled

3800 PARK NICOLLET BLVD, ST LOUIS PARK, MN 55416(952) 993-2498(952) 993-2505 Get Directions Write a Review

NPPES record last updated: June 29, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 11, 2022, Dec 7, 2020 (2 updates tracked since 2020).

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About Samantha Ann Pruitt-johnson NPPES

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

SAMANTHA ANN PRUITT-JOHNSON (NPI 1750987749) is an individual mental health provider in St Louis Park, Minnesota and active in the NPI registry since December 2020. She is enrolled in Medicare PECOS and maintains a secondary practice location in Eagan.

NPPES Registry Identity

NPI1750987749

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameSAMANTHA ANN PRUITT-JOHNSON

Location Address3800 PARK NICOLLET BLVDSt Louis Park, MN 55416-2527

Mailing Address8170 33rd Ave S # Ms 21110qBloomington, MN 55425-4516

Phone(952) 993-2498

Fax(952) 993-2505

Sole ProprietorNo

Enumeration DateDecember 7, 2020

Last NPPES UpdateJune 29, 20222 updates tracked since enumeration

NPPES CertifiedJune 29, 2022

✔ NPI 1750987749 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

3800 PARK NICOLLET BLVD, St Louis Park, MN 55416

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Secondary Practice Location 1

Location 12030 Rahn WayEagan, MN 55122-2300 · Phone (651) 529-1960

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samantha Ann Pruitt-johnson 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.

PETER MCCORMICK SCHAUB PSYD, LP

Psychologist

3800 PARK NICOLLET BLVD
ST LOUIS PARK, MN 55416

Hennepin County (952) 993-3123

DAVID J NUTZ MD

Physical Medicine & Rehabilitation

3800 PARK NICOLLET BLVD
ST LOUIS PARK, MN 55416

Hennepin County (952) 993-3800

GLENN MATFIN M.D.

Internal Medicine (Endocrinology, Diabetes & Metabolism)

3800 PARK NICOLLET BLVD
MINNEAPOLIS, MN 55416

Hennepin County (952) 993-3048

KELLY C GRECO PAC

Physician Assistant

3800 PARK NICOLLET BLVD, DEPARTMENT OF DERMATOLOGY
ST LOUIS PARK, MN 55416

Hennepin County (952) 993-3260

KARLA SUSAN ROSENMAN MD

Dermatology

3800 PARK NICOLLET BLVD, DERMATOLOGY 4TH FLOOR
ST LOUIS PARK, MN 55416

Hennepin County (952) 993-3821

DR. KRISTIN A KUNZMAN PSY.D.

Psychologist (Clinical)

3800 PARK NICOLLET BLVD
ST LOUIS PARK, MN 55416

Hennepin County (952) 993-3393

DR. ALISON M LANG M.D.

Dermatology

3800 PARK NICOLLET BLVD
ST LOUIS PARK, MN 55416

Hennepin County (952) 993-3789

DR. CHUNG M LEE M.D.

Radiology (Diagnostic Radiology)

3800 PARK NICOLLET BLVD
ST LOUIS PARK, MN 55416

Hennepin County (952) 993-3212

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 Samantha Pruitt-johnson's NPI number?

The NPI number for Samantha Pruitt-johnson is 1750987749. It was assigned to this individual provider in the NPPES registry on December 7, 2020.

Where is Samantha Pruitt-johnson located?

Samantha Pruitt-johnson practices at 3800 Park Nicollet Blvd, St Louis Park, MN 55416. The listed phone number is (952) 993-2498.

What is Samantha Pruitt-johnson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Samantha Pruitt-johnson enrolled in Medicare?

Yes. Samantha Pruitt-johnson is registered in the Medicare PECOS enrollment system.

What insurance does Samantha Pruitt-johnson accept?

Health plans from HealthPartners list Samantha Pruitt-johnson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Samantha Pruitt-johnson was last updated on June 29, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.