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Individual

MR. ANDREW A JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
BA BS MSW LICSW LADC

Contact information

Practice address
981 GLENDON ST N, MAPLEWOOD, MN 55119-3811
(612) 354-9027
Mailing address
981 GLENDON ST N, MAPLEWOOD, MN 55119-3811
(612) 354-9027

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
304558
MN
1041C0700X
Clinical Social Worker
Primary
26144
MN

Other

Enumeration date
02/04/2021
Last updated
02/04/2021
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