Matthew Tyler Johnson, LICSW | |
800 Prairie Center Dr Ste 210, Eden Prairie, MN 55344-7306 | |
(612) 888-0544 | |
Not Available |
Full Name | Matthew Tyler Johnson |
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Gender | Male |
Speciality | Counselor - Mental Health |
Location | 800 Prairie Center Dr Ste 210, Eden Prairie, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1487227229 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | 27484 (Minnesota) | Primary |
Entity Name | Canvas Health Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1922051325 PECOS PAC ID: 8729073978 Enrollment ID: O20040416001178 |
Mailing Address | Practice Location Address |
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Matthew Tyler Johnson, LICSW 800 Prairie Center Dr Ste 210, Eden Prairie, MN 55344-7306 Ph: (612) 888-0544 | Matthew Tyler Johnson, LICSW 800 Prairie Center Dr Ste 210, Eden Prairie, MN 55344-7306 Ph: (612) 888-0544 |
Aaron Leander Grier, Counselor Medicare: Not Enrolled in Medicare Practice Location: 7525 Mitchell Rd, Eden Prairie, MN 55344 Phone: 952-224-2282 Fax: 952-224-2284 | |
Peter Joseph Dorsen, Counselor Medicare: Not Enrolled in Medicare Practice Location: 14377 Chestnut Drive, Eden Prairie, MN 55347 Phone: 612-226-3106 | |
Mr. Richard Arthur Rittmaster, LPCC Counselor Medicare: Medicare Enrolled Practice Location: 11010 Prairie Lakes Dr, Suite 350, Eden Prairie, MN 55344 Phone: 952-746-2522 Fax: 952-746-0887 | |
Toby Dennert, Counselor Medicare: Not Enrolled in Medicare Practice Location: 7525 Mitchell Rd, Suite 100, Eden Prairie, MN 55344 Phone: 952-224-2282 | |
Claire Rosen, MA, LPCC, LADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 800 Prairie Center Dr Ste 210, Eden Prairie, MN 55344 Phone: 952-234-9210 | |
Mrs. Susan Elizabeth Zaugg, LADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 11010 Prairie Lakes Dr Ste 350, Eden Prairie, MN 55344 Phone: 952-746-2522 | |
Josi Wylynn Carter, LADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 11010 Prairie Lakes Dr Ste 350, Eden Prairie, MN 55344 Phone: 952-746-2522 |