Individual
MR. ALEX NICHOLAS COFFEY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW LICSW LADC
Contact information
Practice address
3450 OLEARY LN, EAGAN, MN 55123-2340
(651) 454-0114
(651) 454-3492
Mailing address
3450 OLEARY LN, EAGAN, MN 55123-2340
(651) 454-0114
(651) 454-3492
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
302688
MN
1041C0700X
Clinical Social Worker
Primary
21849
MN
Other
Enumeration date
02/13/2013
Last updated
04/22/2016
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