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NPI Code Detail

MEDICARE: ZOE CHRYSEMA JOHNSON LPC

MEDICARE: ZOE CHRYSEMA JOHNSON LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor02988MN

General Provider Information

NPI Number : 1629814132
Entity Type Code : Individual
Provider Name (Legal Business Name) : ZOE CHRYSEMA JOHNSON LPC
Provider Business Mailing Address
First Line : 4051 SHERIDAN AVE S
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55410-1256
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1345 MENDOTA HEIGHTS RD STE 600
Second Line :
City : MENDOTA HEIGHTS
State : MN
Zip : 55120-2007
Country : US
Telephone Number : 651-615-4683
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2024
Last Update Date : 07/10/2024

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Directions to “ ZOE CHRYSEMA JOHNSON LPC” Practice Location

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