Healthcare Provider Details

I. General information

NPI: 1831679422
Provider Name (Legal Business Name): MEGAN JOHNSON LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2018
Last Update Date: 10/16/2024
Certification Date: 10/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 E 6TH ST STE 102
MORRIS MN
56267-1362
US

IV. Provider business mailing address

105 2ND AVE NE STE 110
GLENWOOD MN
56334-1226
US

V. Phone/Fax

Practice location:
  • Phone: 320-428-0744
  • Fax: 320-438-2829
Mailing address:
  • Phone: 320-428-0744
  • Fax: 320-438-2829

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number3479
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3479
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: