Marlon Johnson, LPC, LICDC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

E.2202779 Issued in OH

Practice address

1744 Payne Ave
Cleveland, OH 44114-2910

Phone

(216) 623-6555

NPI assigned

Nov 1, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Marlon L Johnson Counseling and Consulting Firm

  • Mental Health Counselor
  • Brooklyn, OH
  • NPI 1205601531
  NPD Authorized official
• Florence Kimbo M.D., LLC

  • Psychiatry Physician
  • Middleburg Heights, OH
  • NPI 1457788960
  Medicare reassignment
• Lake-Geauga Recovery Centers, Inc.

  • Substance Abuse Rehabilitation Facility
  • Mentor, OH
  • NPI 1750489779
  Medicare reassignment

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

{
    "created_epoch": "1477958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1154873685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4314 S PARKSIDE DR",
            "city": "BROOKLYN",
            "state": "OH",
            "postal_code": "441442724",
            "telephone_number": "216-970-8307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1744 PAYNE AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441142910",
            "telephone_number": "216-623-6555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARLON",
        "credential": "LPC, LICDC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-11-01",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC.162004",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.2202779",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0391321",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Cleveland",
            "affiliation": "N",
            "address_1": "4314 S Parkside Dr",
            "city": "Brooklyn",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441442724",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lowanda Lee Johnson
• Lynne Johnson
• Marcia Johnson, N.P.
• Marilyn Mary Johnson, OD
• Mark Anthony Johnson Jr., LMT
• Martita Johnson
• Mary Johnson
• Mary E Johnson
• Matthew Dean Johnson, MD
• Mattie Renee Johnson, LPN

• Professional Counselor in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.