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

Marissa Johnson, LICSW

Individual provider Social Worker · NPI 1407725328

Marissa Johnson, LICSW is a Clinical Social Worker in Roseau, Minnesota. Qualified in 2022, 4 years ago. Licensed in Minnesota.

Years since qualifying
4
Licensed in
MN
In the registry since
2025
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

See every abbreviation used in this directory →

Practice location Address checks out

715 Delmore Dr
Roseau, MN 56751-1599
Phone: (218) 463-2500
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Social Worker (primary) Taxonomy 104100000X · Licence 31021 (MN)

Record details

NPI number1407725328
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorNo
NPI enumeratedOctober 30, 2025
Last updated in NPPESOctober 30, 2025
Certification dateOctober 30, 2025
Mailing address715 Delmore Dr, Roseau, MN 56751-1599

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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