Karissa Lynne Johnson

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801096711 Issued in MI

Practice address

2200 Genoa Business Park Dr Ste 100
Brighton, MI 48114-5328

Phone

(810) 494-7180

Fax

(810) 215-1334

NPI assigned

Oct 14, 2020

Last updated

Oct 14, 2020By 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 1

Addresses

Other names 1

• Karissa Lynne Canfield Former name

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

Specialty

Clinical Social Worker

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Downriver Mental Health Clinic PCGroup PAC ID 7911995139, 289 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifestancehealth.karissajohnson@150339.advancedmd-direct.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Downriver Mental Health Clinic PC

  dba LifeStance Health

  • Psychologist
  • Taylor, MI
  • NPI 1295866135

  Clinical

  Medicare reassignment Care Compare group NPD
• Downriver Mental Health Clinic PC

  dba Advanced Counseling Services PC

  • Psychologist
  • Taylor, MI
  • NPI 1104930130

  Clinical

  NPD

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

{
    "created_epoch": "1602633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1740888429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 TORREY RD STE 100",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484303327",
            "telephone_number": "810-494-7180",
            "fax_number": "810-215-1334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 GENOA BUSINESS PARK DR STE 100",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481145328",
            "telephone_number": "810-494-7180",
            "fax_number": "810-215-1334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KARISSA",
        "middle_name": "LYNNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-14",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801096711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KARISSA",
            "last_name": "CANFIELD",
            "middle_name": "LYNNE",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• John D. Papadopoulos DDS PLLC (Schoolhouse Family Dentistry)
• Kelly Johns, DPT
• Alexandra Lea Johnson, MD
• Beth Ellen Johnson, AU.D.
• Emma Leigh Johnson
• Logan Anthony Johnson, OTR
• Lori Johnson
• Rollie Johnson
• Carrie Lynn Johnston, MA, TLLP
• Rebecca Ruth Jokinen, MA, LPC, NCC

• Clinical Social Worker in Brighton, MI
• Providers in Brighton, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.