| Jan Johnson | |
|
201 6th St Ne Staples MN 56479-2431 | |
| (218) 894-0034 | |
| Not Available |
| Full Name | Jan Johnson |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 201 6th St Ne, Staples, Minnesota |
| Authorized Official Name and Position | Jan J Johnson (DIRECTOR) |
| Authorized Official Contact | 2188940034 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jan Johnson 518 2nd Ave Ne Staples MN 56479-2930 Ph: (218) 894-2412 | Jan Johnson 201 6th St Ne Staples MN 56479-2431 Ph: (218) 894-0034 |
| NPI Number | 1093920951 |
|---|---|
| Provider Enumeration Date | 05/14/2007 |
| Last Update Date | 07/16/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093920951 | NPI | - | NPPES |
| 437100000 | Other | MN | MHCP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 1039408-1-CDT (Minnesota) | Primary |
Lakewood Health System Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 401 Prairie Ave. N., 49725 Co. Hwy 83, Staples, MN 56479 Phone: 218-894-8204 Fax: 218-894-8219 |