Mary Lee Johnson

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6802065598 Issued in MI

Practice address

3353 Lousma Dr SE
Wyoming, MI 49548-2251

Phone

(616) 241-6258

Fax

(616) 241-6470

NPI assigned

Feb 10, 2015

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

State licenses

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

{
    "created_epoch": "1423526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423526400000",
    "number": "1992196133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 BLACKBURN ST SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495091933",
            "telephone_number": "616-245-9371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3353 LOUSMA DR SE",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495482251",
            "telephone_number": "616-241-6258",
            "fax_number": "616-241-6470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARY",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-10",
        "last_updated": "2015-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6802065598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory W Johnson, M.D.
• Jennifer Lynn Johnson, BSN, RN
• Kathryn M Johnson, LBSW, QIDP
• Kurt M Johnson, RPH.
• Maikayla Dion Johnson
• Mindy Lee Johnson, LMSW
• Scott A Johnson, D.O.
• Shawna Johnson, BSW
• Lauren Brooke Johnston
• Amon Jones

• Social Worker in Wyoming, MI
• Providers in Wyoming, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2015; 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.