Susan Johnston, LICSW
Social Worker, Clinical in Minneapolis, MN. Individual provider (NPI-1).
NPI number1346355880
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1346355880
- Entity type
- Individual (NPI-1)
- Name
- Susan Johnston
- Credential
- LICSW
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Aug 21, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 01165 | MN | Yes |
Practice location
4306 Bryant Ave SMinneapolis, MN 55409-1709
Phone 612-822-3925
Mailing address
4201 Dupont Ave SMinneapolis, MN 55409-1714
Phone 612-822-4633
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