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Contact Information

HEATHER J JOHNSON, PSYD
4601 EXCELSIOR BLVD STE 411
SAINT LOUIS PARK, MN55416-4977
 Phone: 612-294-9458
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Counseling

103TC1900X 62 Psychologist, Clinical
 

Addiction (Substance Use Disorder)

103TA0400X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for HEATHER J JOHNSON · (Female)

NPI Number 1053631622
Status Active
Credentials PSYD (Doctor of Psychology)
Entity Individual
Enumeration date 06/07/2010
Last updated 02/11/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • MN License # 5388
  • MN Medicaid 174658000
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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