Provider Demographics
NPI:1912728858
Name:JOHNSEN, BRITTAN LESLIE (LPC)
Entity type:Individual
Prefix:
First Name:BRITTAN
Middle Name:LESLIE
Last Name:JOHNSEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:BRITT
Other - Middle Name:LESLIE
Other - Last Name:JOHNSEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:3255 COACHMAN RD APT 114
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55121-1852
Mailing Address - Country:US
Mailing Address - Phone:952-491-3235
Mailing Address - Fax:
Practice Address - Street 1:7300 147TH ST W STE 600
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-7850
Practice Address - Country:US
Practice Address - Phone:952-997-3020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional