Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kathryn Marie Johncox, LICSW

Individual provider Clinical Social Worker · NPI 1982376612

Kathryn Marie Johncox, LICSW is a Clinical Social Worker in Apple Valley, Minnesota. Qualified in 2019, 7 years ago. Practices as a sole proprietor. Licensed in Minnesota.

Years since qualifying
7
Licensed in
MN
In the registry since
2021
Specialties on file
2
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

14665 Galaxie Ave Ste 140
Apple Valley, MN 55124-4509
Phone: (651) 456-8494
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X (MN)
Clinical Social Worker Taxonomy 1041C0700X · Licence 28604 (MN)

Record details

NPI number1982376612
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorYes
NPI enumeratedSeptember 30, 2021
Last updated in NPPESApril 22, 2026
Certification dateApril 22, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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