Healthcare Provider Details

I. General information

NPI: 1740111475
Provider Name (Legal Business Name): JOSELYN JOHNSTONE LPCC, LADC
Entity Type: Individual
Gender:
Sole Proprietor: N

Provider Other Name: JO JOHNSTONE

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 3RD AVE S STE 100
MINNEAPOLIS MN
55401-2551
US

IV. Provider business mailing address

1017 OXFORD ST N
SAINT PAUL MN
55103-1245
US

V. Phone/Fax

Practice location:
  • Phone: 612-314-6704
  • Fax:
Mailing address:
  • Phone: 651-206-0523
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5570
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: