NPI 1023346012

Jordan Lee Johnson, MALPCLPCC

Practitioner Professional Counselor Stillwater, MN

Practice location

Address: 6303 Osgood Ave N, Stillwater, MN 55082-6101
Phone: (651) 383-4800
Fax: (651) 383-4801

Registered specialties (2)

Professional Counselor Primary

Behavioral Health & Social Service Providers Taxonomy 101YP2500X Licence CC00629 (MN)

Other Counselor providers in Minnesota →

Professional Counselor

Behavioral Health & Social Service Providers Taxonomy 101YP2500X Licence 4851-125 (WI)

Registry record

NPI: 1023346012
Entity type: Individual
Sex (as registered): Male
NPI issued: 2 Dec 2009
Record last updated: 3 Oct 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.