Nicole M. Johnson, Psyd, LP, LLC
NPI 1649893587ActiveOrganization· Psychologist, Clinical· Burnsville, MN
Psychologist, Clinical in Burnsville, Minnesota, registered in NPPES in May 2020. The authorized official on file is Nicole M. Johnson Psyd Lp, LP, Owner/Licensed Psychologist. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1649893587 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 27, 2020 |
| Last updated in NPPES | Sep 11, 2020 |
| Certified by provider | Sep 11, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Clinical Primary | 103TC0700X | — | — |
| Psychologist, Cognitive & Behavioral | 103TB0200X | — | — |
| Psychologist, Clinical Child & Adolescent | 103TC2200X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MN) |
|---|
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