Candace Rae Johnson, LICSW, LADC
NPI 1912638552ActiveIndividual· Student in an Organized Health Care Education/Training Program· Saint Paul, MN
Student in an Organized Health Care Education/Training Program (LICSW, LADC) with Emily Program P C, practicing in Saint Paul, Minnesota. Enrolled in Medicare as practitioner - clinical social worker.
Overview
| NPI | 1912638552 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LICSW, LADC |
| Sole proprietor | No |
| NPI issued | Jun 23, 2022 |
| Last updated in NPPES | Sep 27, 2024 |
| Certified by provider | Sep 27, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Student in an Organized Health Care Education/Training Program Primary | 390200000X | 30874 | MN |
| Social Worker, Clinical | 1041C0700X | 30874 | MN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Social Worker (MN) |
|---|
Education and affiliations
| Graduation year | 2021 |
|---|---|
| Medicare specialty | Clinical Social Worker |
Medical group
- Emily Program P CSt Louis Park, MN · 51 clinicians
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