Individual provider · Type 1 NPI

Candace Rae Johnson, LICSW, LADC

Student in an Organized Health Care Education/Training Program · St. Paul, MN

NPI number 1912638552 Active

Practice location

2230 Como Ave
St. Paul, MN 55108-1720

Call (612) 730-9429 Map

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker 1041C0700X30874 (MN)
Student in an Organized Health Care Education/Training Program Primary 390200000X30874 (MN)

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1912638552

Candace Rae Johnson, LICSW, LADC's National Provider Identifier is 1912638552, issued on Jun 23, 2022. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in St. Paul, MN. The record was last updated on Sep 27, 2024.