Provider Demographics
NPI:1972396240
Name:JOHNSON, NATHAN AARON JAMES (LPC)
Entity type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:AARON JAMES
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 HAGGE ST
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:56187-1135
Mailing Address - Country:US
Mailing Address - Phone:507-329-6235
Mailing Address - Fax:
Practice Address - Street 1:222 W SUPERIOR ST STE 200
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55802-1939
Practice Address - Country:US
Practice Address - Phone:218-606-1100
Practice Address - Fax:218-520-1799
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2933251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health