MARK JOHNSON SR. (NPI# 1902277734) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902277734 |
| Entity Type | Individual |
| Full Name | MARK JOHNSON SR. |
| Credential | LADC,CPP |
| Practice Address |
5310 Eagle Creek Blvd Shakopee MN 55379-8617 |
| Practice Telephone | 6128396265 |
| Mailing Telephone | 6128396265 |
| Enumeration Date | 2015-10-20 |
| Last Update Date | 2015-10-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
303918 | MN | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427528546 | Mark Johnson | Urology | 278 Franklin Rd Ste 150, Brentwood, TN 37027-3265 | 2018-12-01 |
| 1437692787 | Mark Johnson | Pharmacist | 500 N Claude Lord Boulevard, Pottsville, PA 17901-3868 | 2016-11-18 |
| 1295175966 | Mark Johnson | Pharmacist | 418 Opal Ln, Hibbing, MN 55746-3844 | 2013-06-26 |
| 1275971988 | Mark A Johnson | Dentist | 1714 W Hunt Hwy Ste 100, Queen Creek, AZ 85143-5245 | 2013-06-05 |
| 1598009938 | Mark R Johnson | Pharmacist | 273 12th St Ne, Unit 313, Atlanta, GA 30309-3853 | 2012-11-26 |
| 1164778619 | Mark Anthony Johnson | Pharmacist | 3449 Rezanof Drive, Kodiak, AK 99615 | 2012-08-01 |
| 1881953578 | Mark Joseph Johnson | Anesthesiology | 2810 N Swan Rd Ste 1002810n, Tucson, AZ 85712-6305 | 2012-05-15 |
| 1811261662 | Mark Johnson | Physical Therapist | 3303 Sw Bond Ave Fl 1, Portland, OR 97239-4501 | 2012-02-25 |
| 1639470636 | Mark Johnson | Counselor | 4314 W Lovers Ln, Dallas, TX 75209-2804 | 2010-11-06 |
| 1164743449 | Mark Daniel Johnson | Acupuncturist | 19215 32nd Ave Ne, Lake Forest Park, WA 98155-2525 | 2010-06-21 |
| Street Address |
5310 EAGLE CREEK BLVD |
| City | SHAKOPEE |
| State | MN |
| Zip Code | 55379-8617 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073123030 | True North Community Dental Clinic, LLC | Dentist | 415 East First Avenue, Shakopee, MN 55379 | 2020-08-05 |
| 1154988236 | Benedictine Living Community of Shakopee LLC | Assisted Living Facility | 1705 Windermere Way, Shakopee, MN 55379 | 2019-05-23 |
| 1346741394 | Expressions In Motion LLC | Speech-Language Pathologist | 1221 East 4th Ave., Shakopee, MN 55379 | 2018-02-26 |
| 1124529334 | A.m Dental Professionals P.a | Clinic/Center | 1036 1st Ave E, Shakopee, MN 55379 | 2018-02-22 |
| 1538522024 | Jesse Sylvester | Chiropractor | 1275 Ramsey Street South, #600, Shakopee, MN 55379 | 2016-04-01 |
| 1376903963 | Dakota Best Transportation LLC | Non-emergency Medical Transport (VAN) | 449 Dakota Street Apt 2, Shakopee, MN 55379 | 2016-02-25 |
| 1568856631 | Tatyana Mishkin Gleyzer | Nurse Practitioner | 1010 West Sixth Avenue, Shakopee, MN 55379 | 2015-03-26 |
| 1245634039 | Kalli Ledel | Pharmacist | 1198 Vierling Dr, Cub Pharmacy, Shakopee, MN 55379 | 2014-10-22 |
| 1487992913 | Jennifer Elizabeth Boyd | Nurse Practitioner | Pediatrics 1415 St Francis Ave, Park Nicollet Clinic-shakopee, Shakopee, MN 55379 | 2013-01-17 |
| 1013253798 | Acts Therapy LLC | Counselor | 8170 Old Carriage Court North, 215, Shakopee, MN 55379 | 2012-12-27 |
| Find all providers in zip 55379 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255978490 | A Way Out Sober Living | Counselor | 1240 3rd Ave E Ste 107, Shakopee, MN 55379-1749 | 2019-12-06 |
| 1952791352 | Michelle Bahr | Counselor | 287 Marschall Rd Ste 105, Shakopee, MN 55379-1678 | 2015-01-23 |
| 1609146364 | The Scott County Jail Treatment Program | Counselor | 301 Fuller St S, Shakopee, MN 55379-1322 | 2012-01-11 |
| 1073676672 | Haven Chemical Health Systems, LLC | Counselor | 235 First Avenue East, Shakopee, MN 55379 | 2006-12-18 |
| 1659843860 | American Rehab Services | Counselor | 327 Marschall Rd Ste 395, Shakopee, MN 55379-1680 | 2018-12-28 |
| 1700257052 | Megan Giesen | Counselor | 200 4th Ave W, Shakopee, MN 55379-1220 | 2015-10-13 |
| 1508263039 | Stepping Stones Counseling LLC | Counselor | 8170 Old Carriage Ct, Suite 200, Shakopee, MN 55379-3163 | 2014-11-26 |
| 1750796199 | Samantha Johnson | Counselor | 200 4th Ave W, Suite 300, Shakopee, MN 55379-1220 | 2014-06-24 |
| 1922295674 | Jennifer Lynn Schuldt | Counselor | 200 4th Ave W, Government Center Rm 300, Shakopee, MN 55379-1220 | 2007-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790386456 | Alexandra Lloyd Conroy | Counselor | 3227 Lake Shore Boulevard, Minnetonka, MN 55391 | 2020-11-07 |
| 1134720212 | Rachel Renee Przekwas | Counselor | 216 Center St W Ste 101, Roseau, MN 56751-1494 | 2020-11-04 |
| 1568062461 | Andrew Moe | Counselor | 2118 Blaisdell Ave S., Minneapolis, MN 55404 | 2020-10-29 |
| 1215537477 | Hannah Mae Kidder | Counselor | 1605 Welcome Ave N, Golden Valley, MN 55422-4429 | 2020-10-27 |
| 1649879339 | Jordan Lowe | Counselor | 4615 Grand Ave Ste 300, Duluth, MN 55807-2749 | 2020-10-22 |
| 1417556762 | Jacob R Poppinga | Counselor | 13045 Falcon Dr Ste 7404th, Baxter, MN 56425-4201 | 2020-10-19 |
| 1598362014 | Jeremy Krekula | Counselor | 102 Main St N Ste 100, Stewartville, MN 55976-2608 | 2020-10-07 |
| 1235736786 | Catherine Ann Jaksha | Counselor | 1180 Cushing Cir Apt 217, Saint Paul, MN 55108-5016 | 2020-10-07 |
| 1952908881 | Sutton Outpatient Services, LLC | Counselor | 1700 Livingston Ave Ste 120, West St Paul, MN 55118-5938 | 2020-10-05 |
| 1750998423 | Recovery Alliance Duluth | Counselor | 206 W 4th St Ste 203, Duluth, MN 55806-2659 | 2020-09-28 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.