TIFFANY IRENE JOHNSON (MSW, LICSW) – Clinical Social Worker, NPI 1982063657

TIFFANY IRENE JOHNSON (MSW, LICSW) is a healthcare provider. based in Golden valley, Minnesota. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials MSW, LICSW. They hold a License No. 21005 (MN). The NPI Number for TIFFANY IRENE JOHNSON (MSW, LICSW) is 1982063657

Main info

Female
15 Years Of Experience
Accepts Medicare Assignment
Name
TIFFANY IRENE JOHNSON (MSW, LICSW)
NPI
1982063657
Phone
(763) 225-4052
Address
5905 GOLDEN VALLEY RD STE 100
Enumeration Date
23 February 2016
Last Update Date
23 December 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7632254052
Graduation Year
2011 (15 years ago)
PAC ID
2062710056
Group Practice PAC ID
8123050259
Professional Enrollment ID
I20160407000149
Address ID
MN554283019NE9220XRDXX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness85
Years active:10State licenses:1Digital endpointsOther names

2,310 CLINICAL SOCIAL WORKER in MN

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Provider Addresses for TIFFANY IRENE JOHNSON (MSW, LICSW)

  • Golden Valley Road, Golden Valley, Meander Valley, Tasmania, Australia

    GOLDEN VALLEY, MN 554224455

    Phone: (763) 225-4052

    Fax: (888) 965-5130

    Type: Mailing

  • 7625 METRO BLVD STE 200

    MINNEAPOLIS, MN 554393079

    Phone: (763) 225-4052

    Fax: (888) 965-5130

    Type: Mailing

  • 9220 BASS LAKE RD STE 255

    NEW HOPE, MN 554283019

    Phone: (763) 252-4502

    Fax: (888) 965-5130

    Type: Location

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: 2016-04-07

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
I20160407000149IClinical Social WorkerMNTBD

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 55422)

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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: 8123050259View full group profile
NameSpecialtyState
-MN
Clinical Social WorkerMN
Clinical Social WorkerMN
Clinical Social WorkerMN
Nurse PractitionerMN
Clinical Social WorkerMN
Marriage And Family TherapistMN

Reviews

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Frequently asked questions

How is TIFFANY IRENE JOHNSON (MSW, LICSW) identified in CMS data?
CMS-hosted NPPES data lists TIFFANY IRENE JOHNSON (MSW, LICSW) with NPI 1982063657.
Is TIFFANY IRENE JOHNSON (MSW, LICSW) still practicing?
TIFFANY IRENE JOHNSON (MSW, LICSW) is currently listed as active in the public NPI registry.
What is TIFFANY IRENE JOHNSON (MSW, LICSW)'s primary classification?
Clinical Social Worker is the headline specialty for TIFFANY IRENE JOHNSON (MSW, LICSW) here. Clinical services aligned with this taxonomy classification.
What area does TIFFANY IRENE JOHNSON (MSW, LICSW) serve?
TIFFANY IRENE JOHNSON (MSW, LICSW)'s listing highlights Golden Valley, Minnesota; more addresses can appear in NPPES.
Why does TIFFANY IRENE JOHNSON (MSW, LICSW) have multiple addresses?
4 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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