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

Matthew Tyler Johnson, LICSW

Individual provider Mental Health Counselor · NPI 1487227229

Matthew Tyler Johnson, LICSW is a Mental Health Counselor in Edina, Minnesota. Practices as a sole proprietor. Licensed in Minnesota.

Licensed in
MN
In the registry since
2021
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

4820 77th St W Ste 117
Edina, MN 55435-4809
Phone: (612) 208-2762
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 27484 (MN)

Record details

NPI number1487227229
Entity typeIndividual (Type 1)
GenderMale
Credentials LICSW
Sole proprietorYes
NPI enumeratedJuly 20, 2021
Last updated in NPPESJanuary 16, 2025
Certification dateJanuary 16, 2025

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