Serena A Johnson, LLMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6851107290 Issued in MI

Practice address

14331 Rutland St
Detroit, MI 48227-1317

Phone

(248) 971-9327

NPI assigned

Aug 12, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Locations

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.

• Downriver Mental Health Clinic PC

  • Psychologist
  • Taylor, MI
  • NPI 1295866135
  Medicare reassignment NPD
• Neighborhood Service Organization

  • Community/Behavioral Health Agency
  • Detroit, MI
  • NPI 1891825808
  Medicare reassignment NPD
• Downriver Mental Health Clinic PC

  • Psychologist
  • Taylor, MI
  • NPI 1104930130
  NPD

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

{
    "created_epoch": "1628726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1457026247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29155 NORTHWESTERN HWY # 595",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341011",
            "telephone_number": "248-971-9327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14331 RUTLAND ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482271317",
            "telephone_number": "248-971-9327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SERENA",
        "middle_name": "A",
        "credential": "LLMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-12",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6851107290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rodney Johnson
• Roger K Johnson, LPC
• Roxie Johnson, SWT
• Samara Johnson
• Sandra Johnson
• Shanae Johnson
• Shanonielle Johnson, RN
• Shantae Monae Johnson, AGACNP-BC
• Shara L. Johnson, PH.D.
• Sharniece Alexis Johnson

• Social Worker in Detroit, MI
• Providers in Detroit, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; 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.