Candace Rae Johnson, LICSW, LADC is a
Student In An Organized Health Care Education/training Program based in Saint Paul, Minnesota. Candace Rae Johnson is licensed to practice in Minnesota (license number 30874) and her current practice location is
2230 Como Ave, Saint Paul, Minnesota. She can be reached at her office (for appointments etc.) via phone at
(612) 730-9429.
NPI number for Candace Rae Johnson is 1912638552 and her current mailing address is 2230 Como Ave, Saint Paul, Minnesota. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1912638552.
Healthcare Provider's Profile
| Full Name | Candace Rae Johnson |
|---|
| 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 | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1912638552
- Provider Enumeration Date: 06/23/2022
- Last Update Date: 09/27/2024
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 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
NOT enrolled with medicare and thus cannot 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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