Mr Alex Nicholas Coffey Johnson, MSW LICSW LADC is a medicare enrolled "Social Worker - Clinical" provider in Eagan, Minnesota. His current practice location is
3450 Oleary Ln, Eagan, Minnesota. You can reach out to his office (for appointments etc.) via phone at
(651) 454-0114.
Mr Alex Nicholas Coffey Johnson is licensed to practice in Minnesota (license number 21849) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1578802336.
Healthcare Provider's Profile
| Full Name | Mr Alex Nicholas Coffey Johnson |
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| Gender | Male |
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| Speciality | Social Worker - Clinical |
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| Location | 3450 Oleary Ln, Eagan, Minnesota |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1578802336
- Provider Enumeration Date: 02/13/2013
- Last Update Date: 04/22/2016
Medicare PECOS Information:
- PECOS PAC ID: 9436465705
- Enrollment ID: I20150901001578
Medical Identifiers
Medical identifiers for Mr Alex Nicholas Coffey Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1578802336 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 302688 (Minnesota) | Secondary |
| 1041C0700X | Social Worker - Clinical | 21849 (Minnesota) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Alex Nicholas Coffey Johnson allows following entities to bill medicare on his behalf.
| Entity Name | Eagan Counseling Clinic |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1144311184 PECOS PAC ID: 2860304045 Enrollment ID: O20031105000326 |
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| Entity Name | Centerlife Counseling LLC |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1417283946 PECOS PAC ID: 0547391187 Enrollment ID: O20100626000182 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Alex Nicholas Coffey Johnson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Mr Alex Nicholas Coffey Johnson, MSW LICSW LADC 3450 Oleary Ln, Eagan, MN 55123-2340 Ph: (651) 454-0114 | Mr Alex Nicholas Coffey Johnson, MSW LICSW LADC 3450 Oleary Ln, Eagan, MN 55123-2340 Ph: (651) 454-0114 |
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