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JODY REIS-JOHNSON M.DIV.MSW LICSW NPI 1740375740


NPI Information

NPI: 1740375740
Provider Name: JODY REIS-JOHNSON, M.DIV.,MSW, LICSW
Classification: Social Worker - 1041C0700X
Entity Type: Individual

Specialization: Clinical

Address:
3450 OLEARY LN
EAGAN, MN
ZIP 55123
Phone: (651) 454-0114
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Jody Reis-johnson, M.DIV.,MSW, LICSW is a clinical social worker in Eagan, MN. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. Jody Reis-johnson, M.DIV.,MSW, LICSW NPI is 1740375740. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3450 OLEARY LN
EAGAN, MN
ZIP 55123-340
Phone: (651) 454-0114
Fax: (651) 454-3492

The enumeration date for this NPI number is 10/4/2006 and was last updated on 7/8/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11041C0700XSocial WorkerClinical06627MINNESOTAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1599K6JOOTHERMINNESOTABCBS
262-76634OTHERMICRONESIAUBH
3HP27073OTHERMINNESOTAHEALTHPARTNERS
4157857000OTHERMINNESOTAMN CARE
5800001682MEDICARE ID-TYPE UNSPECIFIEDMINNESOTAMEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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