NPIMap

Organization Active NPI

Detroit Health & Wellness, PLLC

  • Clinical Psychologist
  • Detroit, MI
National Provider Identifier
1285284794
Registry record updated Sep 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
DETROIT HEALTH & WELLNESS, PLLC
Practice address
1001 Woodward Ave FL 5
Detroit, MI 48226-1904
Phone
(313) 739-7836
Fax
(313) 557-1662
NPI assigned
Sep 17, 2019
Last updated
Sep 17, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2019

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

Authorized official

Name
Dr. Sandra Kristine Johnson, PH.D.
Title
Clinical Director
Phone
(248) 766-3209

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X Primary

Addresses

Primary practice location

1001 Woodward Ave FL 5
Detroit, MI 48226-1904

Mailing address

8200 E Jefferson Ave Apt 1604
Detroit, MI 48214-3978
Phone (248) 766-3209

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1568678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568678400000",
    "number": "1285284794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8200 E JEFFERSON AVE APT 1604",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482143978",
            "telephone_number": "248-766-3209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 WOODWARD AVE FL 5",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482261904",
            "telephone_number": "313-739-7836",
            "fax_number": "313-557-1662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DETROIT HEALTH & WELLNESS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-17",
        "last_updated": "2019-09-17",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "KRISTINE",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "248-766-3209",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "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 Sep 17, 2019; 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.