Individual provider Active NPI

Michelle Rose Johnson, LPC

  • Counselor
  • Avondale, AZ
National Provider Identifier
1952922189
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
LPC-18926 Issued in AZ
Practice address
235 W Western Ave
Avondale, AZ 85323-1848
Phone
(602) 230-7373
Fax
(602) 230-3086
NPI assigned
Apr 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X LPC-18926 AZ Primary
Professional Counselor 101YP2500X LPC-18926 AZ

Addresses

Primary practice location

235 W Western Ave
Avondale, AZ 85323-1848

Mailing address

3101 N Central Ave Ste 550
Phoenix, AZ 85012-2635
Phone (602) 230-7373

Other practice location 1

3330 N 2nd St Ste 601
Phoenix, AZ 85012-2395
Phone (602) 230-7373

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL mjohnson@denova.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20240115001053 AZ Practitioner - Mental Health Counselor 7517319676 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Denova Collaborative Health, LLCGroup PAC ID 2466437736, 141 clinicians

Practice addresses (Care Compare)

235 W Western Ave
Avondale, AZ 85323-1848
Phone (602) 230-7373

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC-18926AZMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Denova Collaborative Health, LLC CurrentSince Jan 1, 2024 Accepting new patients
Denova Collaborative Health, LLC Current Accepting new patients
Denova Collaborative Health, LLC CurrentSince Jan 1, 2024 Accepting new patients
Denova Collaborative Health, LLC Past Accepting new patients

Locations

506 E Western Ave
Ste 104
Avondale, AZ 85323

235 W Western Ave
Avondale, AZ 85323
Phone (623) 772-5091

2204 S Dobson Rd
Mesa, AZ 85202
Phone (480) 757-6457

2120 W Guadalupe Rd
Ste 6
Mesa, AZ 85202
Phone (480) 629-8577

2204 S Dobson Rd
Ste 201
Mesa, AZ 85202
Phone (602) 374-4410

2204 S Dobson Rd
Ste 102
Mesa, AZ 85202

9014 S Central Ave
Phoenix, AZ 85042
Phone (602) 384-8820

3033 N Central Ave
Ste 700
Phoenix, AZ 85012
Phone (602) 281-7289

3330 N 2nd St
Ste 601
Phoenix, AZ 85012
Phone (602) 234-3444

77 E Columbus Ave
Ste 210
Phoenix, AZ 85012

3101 N Central Ave
Ste 500
Phoenix, AZ 85012

750 E Thunderbird Rd
Ste 13
Phoenix, AZ 85022
Phone (602) 682-7455

610 E Baseline Rd
Ste C5
Phoenix, AZ 85042

3101 N Central Ave
Ste 550
Phoenix, AZ 85012

610 E Baseline Rd
Ste 5
Phoenix, AZ 85042

Organizations & group practices 4

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": "1588032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1952922189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 N CENTRAL AVE STE 550",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122635",
            "telephone_number": "602-230-7373",
            "fax_number": "602-682-7455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 W WESTERN AVE",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853231848",
            "telephone_number": "602-230-7373",
            "fax_number": "602-230-3086"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3330 N 2nd St Ste 601",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850122395",
            "country_code": "US",
            "telephone_number": "602-230-7373",
            "fax_number": "602-230-5105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MICHELLE",
        "middle_name": "ROSE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-28",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "AZ",
            "license": "LPC-18926",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-18926",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "mjohnson@denova.com",
            "affiliation": "N",
            "endpointDescription": "Work email",
            "address_1": "2204 S Dobson Rd Ste 201",
            "city": "Mesa",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852026457",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Avondale, AZ

Sources for this page

Verify at the official NPI Registry.