Individual provider Active NPI

Malaysha Johnson

  • Social Worker
  • Clarkston, MI
National Provider Identifier
1720628381
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6851115492 Issued in MI
Practice address
6548 Town Center Dr Ste D
Clarkston, MI 48346-4823
Phone
(800) 693-1916
NPI assigned
Jan 12, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Social Worker 104100000X 6851115492 MI Primary

Addresses

Primary practice location

6548 Town Center Dr Ste D
Clarkston, MI 48346-4823

Mailing address

1903 N Main St Apt 101
Royal Oak, MI 48073-4140

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pcerecords.essmichigan@direct.mihin.net Easter Seals - Michigan, Inc.

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

LicenseStateTypeSpecialty
6851115492MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Richard Kneip, PH.D., P.C. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1578787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1720628381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1903 N MAIN ST APT 101",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480734140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6548 TOWN CENTER DR STE D",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483464823",
            "telephone_number": "800-693-1916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MALAYSHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-12",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6851115492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pcerecords.essmichigan@direct.mihin.net",
            "affiliation": "Y",
            "affiliationName": "Easter Seals - Michigan, Inc.",
            "address_1": "2399 E Walton Blvd",
            "city": "Auburn Hills",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483261955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clarkston, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; 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.