Stacia Dwaina Johnson

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

1311 Mamaroneck Ave Ste 150
White Plains, NY 10605-5222

Phone

(914) 328-2868

NPI assigned

Sep 22, 2025

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Up We Grow Services LLC

  • Early Intervention Provider Agency
  • Melville, NY
  • NPI 1841066842
  NPD (past)

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

{
    "created_epoch": "1758499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758499200000",
    "number": "1891667671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 MAMARONECK AVE STE 150",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106055222",
            "telephone_number": "914-328-2868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 MAMARONECK AVE STE 150",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106055222",
            "telephone_number": "914-328-2868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "STACIA",
        "middle_name": "DWAINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-22",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Desiree Johnson
• Gail Johnson, LPN
• Herbert Johnson
• Randa Johnson
• Samantha Johnson
• Taylor Renay Johnson
• Zachary T/C Johnson
• Jennifer Jolley, NP
• Pamela Jones-Brice, LCSW, CASAC
• Carol Joyce Jones, FNP

• Specialist in White Plains, NY
• Providers in White Plains, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 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.