Individual provider · Type 1 NPI

Matthew Tyler Johnson, LICSW

Mental Health Counselor · Edina, MN

NPI number 1487227229 Active

Practice location

4820 77th St W Ste 117
Edina, MN 55435-4809

Call (612) 208-2762 Map

Mailing address

800 Prairie Center Dr Ste 210
Eden Prairie, MN 55344-7306

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X27484 (MN)

Mental Health Counselor: Definition to come...

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About NPI 1487227229

Matthew Tyler Johnson, LICSW's National Provider Identifier is 1487227229, issued on Jul 20, 2021. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Edina, MN. The record was last updated on Jan 16, 2025.