MR. KEVIN A. JOHNSON (LMFT, LADC, CTP) – Marriage & Family Therapist, NPI 1154941474

MR. KEVIN A. JOHNSON (LMFT, LADC, CTP) is a healthcare provider. based in Oakdale, Minnesota. specializing in MARRIAGE AND FAMILY THERAPIST. They hold the professional credentials LMFT, LADC, CTP. They hold a License No. 305116 (MN). The NPI Number for MR. KEVIN A. JOHNSON (LMFT, LADC, CTP) is 1154941474

Main info

Male
7 Years Of Experience
Accepts Medicare Assignment
Name
MR. KEVIN A. JOHNSON (LMFT, LADC, CTP)
NPI
1154941474
Phone
(612) 842-9814
Address
992 INWOOD AVE N
Enumeration Date
17 April 2020
Last Update Date
30 July 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6514725915
Graduation Year
2019 (7 years ago)
PAC ID
4789124892
Group Practice PAC ID
6709317787
Professional Enrollment ID
I20240904001416
Address ID
MN551286625OA992XXNXXX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness75
Years active:6State licenses:2Digital endpointsOther names

981 MARRIAGE AND FAMILY THERAPIST in MN

Provider Addresses for MR. KEVIN A. JOHNSON (LMFT, LADC, CTP)

  • 992 INWOOD AVE N

    OAKDALE, MN 551286625

    Phone: (612) 842-9814

    Type: Mailing

  • 1821 UNIVERSITY AVE W STE N385

    SAINT PAUL, MN 551042872

    Phone: (612) 454-2447

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-09-04

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240904001416IMarriage And Family TherapistMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55128)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6709317787View full group profile
NameSpecialtyState
Marriage And Family TherapistMN
Clinical PsychologistMN
Clinical PsychologistIL
Nurse PractitionerMN
Marriage And Family TherapistMN
Clinical PsychologistMN
Clinical PsychologistWI
Mental Health CounselorMN
Mental Health CounselorMN
Clinical Social WorkerMN

Reviews

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Frequently asked questions

What is the 10-digit NPI for MR. KEVIN A. JOHNSON (LMFT, LADC, CTP)?
MR. KEVIN A. JOHNSON (LMFT, LADC, CTP) — NPI 1154941474 — is the standard way to identify this listing.
Can I rely on MR. KEVIN A. JOHNSON (LMFT, LADC, CTP) being an active provider?
As of the registry snapshot, MR. KEVIN A. JOHNSON (LMFT, LADC, CTP) is marked active.
What taxonomy line describes MR. KEVIN A. JOHNSON (LMFT, LADC, CTP)?
For research purposes, treat MR. KEVIN A. JOHNSON (LMFT, LADC, CTP) as Marriage & Family Therapist in this dataset. Clinical services aligned with this taxonomy classification.
Where should I expect MR. KEVIN A. JOHNSON (LMFT, LADC, CTP) on a map?
Expect Oakdale, Minnesota as a primary anchor for MR. KEVIN A. JOHNSON (LMFT, LADC, CTP) unless the record lists multiple sites.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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