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General NPI Number Information
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NPI Number | 1427131713
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Entity Type | Individual
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Provider Name | JENIFER ELIZABETH JOHN MA LMFT LICSW
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Gender | Female
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 261 BROADWAY ST E
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City | MONTICELLO
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State | MN
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Zip | 55362
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Country | US
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Telephone | 763-262-3077
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Fax | 763-262-1113
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Provider Business Mailing Address
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Address Line | 261 E BROADWAY ST PO BOX 1342
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City | MONTICELLO
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State | MN
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Zip | 55362-9317
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Country | US
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Telephone | 763-232-7403
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Fax | 763-262-1113
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 07448
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 0875
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License Number State | MN
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