Mr Tommie Earl Johnson, LLMSW is a
Prevention Professional based in Grandville, Michigan. Mr Tommie Earl Johnson is licensed to practice in Michigan (license number 680115877) and his current practice location is
3584 Fairlanes Ave Sw Ste 2, Grandville, Michigan. He can be reached at his office (for appointments etc.) via phone at
(616) 222-5300.
NPI number for Mr Tommie Earl Johnson is 1255926143 and his current mailing address is 3584 Fairlanes Ave Sw Ste 2, Grandville, Michigan. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1255926143.
Healthcare Provider's Profile
Full Name | Mr Tommie Earl Johnson |
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Gender | Male |
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Speciality | Prevention Professional |
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Location | 3584 Fairlanes Ave Sw Ste 2, Grandville, Michigan |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1255926143
- Provider Enumeration Date: 03/03/2021
- Last Update Date: 03/03/2021
Medical Identifiers
Medical identifiers for Mr Tommie Earl Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1255926143 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
103TM1800X | Psychologist - Intellectual & Developmental Disabilities | (* (Not Available)) | Secondary |
405300000X | Prevention Professional | 680115877 (Michigan) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Tommie Earl Johnson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mr Tommie Earl Johnson, LLMSW 3584 Fairlanes Ave Sw Ste 2, Grandville, MI 49418-1583 Ph: (616) 222-5300 | Mr Tommie Earl Johnson, LLMSW 3584 Fairlanes Ave Sw Ste 2, Grandville, MI 49418-1583 Ph: (616) 222-5300 |
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