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NPI Code Detail

MEDICARE: TERRELL JOHNSON LLC

MEDICARE: TERRELL JOHNSON LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1720931033
Entity Type Code : Organization
Provider Name (Legal Business Name) : TERRELL JOHNSON LLC
Provider Business Mailing Address
First Line : PO BOX 32227
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55432-0227
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8525 EDINBROOK XING STE 211
Second Line :
City : BROOKLYN PARK
State : MN
Zip : 55443-2060
Country : US
Telephone Number : 612-567-2770
Fax Number :
Authorized Official
Title or Position : SOCIAL WORKER
Name : TERRELL JOHNSON
Credential : LICSW
Telephone Number : 612-567-2770
Provider Enumeration Date : 02/17/2026
Last Update Date : 06/22/2026

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