Michelle Johnson-Mastin

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

680193354 Issued in MI

Practice address

6418 Deans Hill Rd
Berrien Center, MI 49102-8713

Phone

(269) 815-5500

Fax

(269) 815-5373

NPI assigned

Jul 6, 2016

Last updated

Jul 13, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Michelle Johnson, Hart Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1467763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468368000000",
    "number": "1467804104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6418 DEANS HILL RD",
            "city": "BERRIEN CENTER",
            "state": "MI",
            "postal_code": "491028713",
            "telephone_number": "269-815-5500",
            "fax_number": "269-815-5373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6418 DEANS HILL RD",
            "city": "BERRIEN CENTER",
            "state": "MI",
            "postal_code": "491028713",
            "telephone_number": "269-815-5500",
            "fax_number": "269-815-5373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON-MASTIN",
        "first_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-06",
        "last_updated": "2016-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "680193354",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801093354",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "JOHNSON, HART",
            "credential": "LLMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Del Fehsenfeld III, LMFT
• Maybetth Patricia Fernandez-Campos
• Jessica Marie Finnegan
• Sarah Marie Hayslip
• Dahn Mulako Imasiku, DP-C
• Tricia Newland Johnson, L.M.S.W
• Thomas Johnston
• Karen Joy Knauss, RD
• Lakeland Pharmacy Berrien
• Lakeland Specialty Hospital

• Clinical Psychologist in Berrien Center, MI
• Providers in Berrien Center, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2016; 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.