Active NPI
Jalen Johnson
- Social Worker
- Lincoln Park, MI
National Provider Identifier
1184495087
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6851121838
- Practice address
- 26300 Outer Dr
Lincoln Park, MI 48146-2019 - Phone
- (313) 388-4630
- Fax
- (734) 287-2074
- NPI assigned
- Jan 10, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6851121838 | MI | Primary |
Addresses
Primary practice location
26300 Outer Dr
Lincoln Park, MI 48146-2019
Mailing address
14843 Forest St
Southgate, MI 48195-2537
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6851121838 | MI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1704844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780444800000",
"number": "1184495087",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14843 FOREST ST",
"city": "SOUTHGATE",
"state": "MI",
"postal_code": "481952537"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26300 OUTER DR",
"city": "LINCOLN PARK",
"state": "MI",
"postal_code": "481462019",
"telephone_number": "313-388-4630",
"fax_number": "734-287-2074"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "JALEN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-01-10",
"last_updated": "2026-06-03",
"certification_date": "2026-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6851121838",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lincoln Park, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.