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Matthew Johnson, MA LPCC

Counselor, Professional in Minneapolis, MN. Individual provider (NPI-1).

NPI number1265764641
StatusActive
Last updated in NPPESJun 12, 2018

Details

NPI
1265764641
Entity type
Individual (NPI-1)
Name
Matthew Johnson
Credential
MA LPCC
Sex
Male
Sole proprietor
No
Enumeration date
Feb 9, 2010
Last updated
Jun 12, 2018

Medicare and OIG

Medicare enrolled (PECOS)
Yes · PRACTITIONER - MENTAL HEALTH COUNSELOR
Can order and refer
Part B Yes · DME Yes · Home health No · Power mobility No · Hospice No
OIG exclusion list
This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YP2500X Counselor, Professionalcc00100MNYes

Practice location

219 Se Main St Ste 400
Minneapolis, MN 55414

Phone 612-886-2524 · Fax 612-886-2538

Mailing address

219 Se Main St Ste 400
Minneapolis, MN 55414-2151

Phone 612-886-2524 · Fax 612-886-2538

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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

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