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

Mrs. Taylor Paige Johnson, LICSW

Individual provider Clinical Social Worker · NPI 1114889458

Mrs. Taylor Paige Johnson, LICSW is a Clinical Social Worker in Moorhead, 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.

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Practice location Address checks out

819 30th Ave S Ste 102
Moorhead, MN 56560-5000
Phone: (218) 979-3560
Fax: (218) 284-1080
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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 32051 (MN)

Record details

NPI number1114889458
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorNo
NPI enumeratedNovember 25, 2025
Last updated in NPPESDecember 19, 2025
Certification dateDecember 19, 2025

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

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