Healthcare Provider Details

I. General information

NPI: 1568868545
Provider Name (Legal Business Name): AARON A JOHNSEN LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2014
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1615 17TH AVE S
GRAND FORKS ND
58201-5372
US

IV. Provider business mailing address

1615 17TH AVE S
GRAND FORKS ND
58201-5372
US

V. Phone/Fax

Practice location:
  • Phone: 701-795-8550
  • Fax: 701-746-5523
Mailing address:
  • Phone: 701-795-8550
  • Fax: 701-746-5523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number900-4-15-17
License Number StateND
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number900-4-15-17
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: