Dominique Johnson

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Practice address

4673 Washtenaw Ave
Ann Arbor, MI 48108-1301

Phone

(734) 547-5009

NPI assigned

May 15, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1747267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1891586210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 EILEEN ST",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481986239",
            "telephone_number": "734-644-0685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4673 WASHTENAW AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081301",
            "telephone_number": "734-547-5009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1825 Eileen St",
            "address_purpose": "LOCATION",
            "city": "Ypsilanti",
            "state": "MI",
            "postal_code": "481986239",
            "country_code": "US",
            "telephone_number": "734-644-0685",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DOMINIQUE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-15",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corielle Johnson Jr.
• Crystal L Johnson, PA-C
• Delisha Johnson
• Demond Johnson
• Diane M Johnson, CRNA
• Donna Johnson
• Elliot Johnson
• Emily Dorothy Johnson
• Emily Hope Johnson, SLP
• Emily Juliana Johnson, M.A.

• Clinic/Center in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2025; 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.