Individual provider · Type 1 NPI

Tyler Johnson, LICSW

Clinical Social Worker · Cass Lake, MN

NPI number 1215752274 Active

Practice location

16123 Grant Utley Ave NW
Cass Lake, MN 56633

Mailing address

34335 Muskrat Rd
Laporte, MN 56461-4517

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X31432 (MN)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1215752274

Tyler Johnson, LICSW's National Provider Identifier is 1215752274, issued on Nov 15, 2024. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Cass Lake, MN. The record was last updated on Nov 15, 2024.