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

Individual provider Clinical Social Worker · NPI 1578625893

Kenneth Johnson, LICSW is a Clinical Social Worker in Shoreview, Minnesota. Practices as a sole proprietor. Licensed in Minnesota.

Licensed in
MN
In the registry since
2006
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

3570 Lexington Ave N
Shoreview, MN 55126-8049
Phone: (651) 481-0664
Fax: (651) 481-3907
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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 · Licence 495 (MN)

Record details

NPI number1578625893
Entity typeIndividual (Type 1)
GenderMale
Credentials LICSW
Sole proprietorYes
NPI enumeratedDecember 14, 2006
Last updated in NPPESJuly 8, 2007
Mailing address503 Lakewood Dr S, Maplewood, MN 55119-5522

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