Roger K Johnson, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401020284 Issued in MI

Practice address

17384 Beaverland St
Detroit, MI 48219-3154

Phone

(313) 578-1148

NPI assigned

Jul 24, 2023

Sex

Male

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

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

Mental Health Counselor

Education

Wayne State University School of Medicine, 2007

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Horizon Care Medical Group

  • Family Medicine Physician
  • Detroit, MI
  • NPI 1730549841
  Medicare reassignment NPD
• Three Men and a Couch Counseling and Therapy

  • Professional Counselor
  • Detroit, MI
  • NPI 1447084769
  NPD Authorized official

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

{
    "created_epoch": "1690156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1972283919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17384 BEAVERLAND ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482193154",
            "telephone_number": "313-578-1148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17384 BEAVERLAND ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482193154",
            "telephone_number": "313-578-1148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ROGER",
        "middle_name": "K",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-24",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401020284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Johnson
• Phillip D'Juan Johnson
• Raymond Johnson, CRNA
• Robert Edward Sekani Johnson
• Rodney Johnson
• Roxie Johnson, SWT
• Samara Johnson
• Sandra Johnson
• Serena A Johnson, LLMSW
• Shanae Johnson

• Professional Counselor in Detroit, MI
• Providers in Detroit, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; 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.