| Rhonda Johnson, Msw, Licsw Llc | |
|
2006 1st Ave Ste 101 Anoka MN 55303-2255 | |
| (952) 240-0109 | |
| Not Available |
| Full Name | Rhonda Johnson, Msw, Licsw Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2006 1st Ave Ste 101, Anoka, Minnesota |
| Authorized Official Name and Position | Rhonda Johnson (PRIVATE PRACTICE) |
| Authorized Official Contact | 9522400109 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rhonda Johnson, Msw, Licsw Llc 2006 1st Ave Ste 101 Anoka MN 55303-2255 Ph: (952) 240-0109 | Rhonda Johnson, Msw, Licsw Llc 2006 1st Ave Ste 101 Anoka MN 55303-2255 Ph: (952) 240-0109 |
| NPI Number | 1063770139 |
|---|---|
| Provider Enumeration Date | 04/26/2012 |
| Last Update Date | 02/11/2019 |
| Medicare PECOS PAC ID | 1254588965 |
|---|---|
| Medicare Enrollment ID | O20120831000608 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063770139 | NPI | - | NPPES |
| 275413400 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 12066 (Minnesota) | Primary |
| Provider Name | Rhonda M. B. Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285667055 PECOS PAC ID: 7113811407 Enrollment ID: I20040209000857 |
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