Candace Rae Johnson, LICSW, LADC is a medicare enrolled "Student In An Organized Health Care Education/training Program" provider in Saint Paul, Minnesota. Her current practice location is
2230 Como Ave, Saint Paul, Minnesota. You can reach out to her office (for appointments etc.) via phone at
(612) 730-9429.
Candace Rae Johnson is licensed to practice in Minnesota (license number 30874) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1912638552.
Healthcare Provider's Profile
Full Name | Candace Rae Johnson |
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Gender | Female |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 2230 Como Ave, Saint Paul, Minnesota |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1912638552
- Provider Enumeration Date: 06/23/2022
- Last Update Date: 09/27/2024
Medicare PECOS Information:
- PECOS PAC ID: 9537605670
- Enrollment ID: I20240724003598
Medical Identifiers
Medical identifiers for Candace Rae Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1912638552 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1041C0700X | Social Worker - Clinical | 30874 (Minnesota) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | 30874 (Minnesota) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Candace Rae Johnson allows following entities to bill medicare on her behalf.
Entity Name | Introspect Mental Health Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1184273666 PECOS PAC ID: 9931502796 Enrollment ID: O20210730002128 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Candace Rae Johnson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Candace Rae Johnson, LICSW, LADC 2230 Como Ave, Saint Paul, MN 55108-1720 Ph: () - | Candace Rae Johnson, LICSW, LADC 2230 Como Ave, Saint Paul, MN 55108-1720 Ph: (612) 730-9429 |
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