Search › Minnesota › 1041C0700X
Tyler Johnson, LICSW
NPI 1215752274 · on the registry since 2024
Practice
- Address
- 16123 Grant Utley Ave Nw
Cass Lake, MN 56633 - Phone
- (218) 335-3050
- Organisation at this address
- Leech Lake Band Of Ojibwe
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 4
Registry record
- Primary taxonomy
- 1041C0700X
1041C0700X
- Licence states on file
- MN
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2024-11-15
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Minnesota