Individual
ELLEN E JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1313 PENN AVE N, MINNEAPOLIS, MN 55411-3047
(612) 543-2731
(612) 677-6346
Mailing address
1313 PENN AVE N, MINNEAPOLIS, MN 55411-3047
(612) 543-2731
(612) 677-6346
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
20917
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
MN
Enumeration date
02/27/2013
Last updated
02/05/2014
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