Healthcare Provider Details

I. General information

NPI: 1821982182
Provider Name (Legal Business Name): LEE HOWARD JOHNSON LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2025
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 21ST ST SE STE 1
AUSTIN MN
55912-4322
US

IV. Provider business mailing address

101 21ST ST SE STE 1
AUSTIN MN
55912-4322
US

V. Phone/Fax

Practice location:
  • Phone: 507-437-6389
  • Fax: 507-396-4453
Mailing address:
  • Phone: 507-437-6389
  • Fax: 507-396-4453

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number04765
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: