Healthcare Provider Details

I. General information

NPI: 1871696112
Provider Name (Legal Business Name): JAROLYN JOHNSON LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1016 8TH AVENUE SW
PIPESTONE MN
56164
US

IV. Provider business mailing address

216 E LUVERNE ST PO BOX 686
LUVERNE MN
56156-1610
US

V. Phone/Fax

Practice location:
  • Phone: 507-825-5888
  • Fax: 507-825-5880
Mailing address:
  • Phone: 507-283-9511
  • Fax: 507-283-9514

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number886
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: