Individual provider Active NPI

Edward Dushawn Johnson

  • Health Service Psychologist
  • Detroit, MI
National Provider Identifier
1093671893
Registry record updated Dec 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service PsychologistTaxonomy code 103TH0100X
Practice address
9200 W Vernor Hwy Apt 148
Detroit, MI 48209-1443
Phone
(313) 697-3399
NPI assigned
Dec 24, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 24, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TH0100X MI Primary

Addresses

Primary practice location

9200 W Vernor Hwy Apt 148
Detroit, MI 48209-1443

Mailing address

9200 W Vernor Hwy Apt 148
Detroit, MI 48209-1443
Phone (313) 697-3399

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1766534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766534400000",
    "number": "1093671893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 W VERNOR HWY APT 148",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482091443",
            "telephone_number": "313-697-3399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W VERNOR HWY APT 148",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482091443",
            "telephone_number": "313-697-3399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "EDWARD",
        "middle_name": "DUSHAWN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-12-24",
        "last_updated": "2025-12-24",
        "certification_date": "2025-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TH0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Health Service",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.