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NPI Code Detail

MEDICARE: BROOKLYN JOHNSON

MEDICARE: BROOKLYN JOHNSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorCDCA.194428OH

General Provider Information

NPI Number : 1477417517
Entity Type Code : Individual
Provider Name (Legal Business Name) : BROOKLYN JOHNSON
Provider Business Mailing Address
First Line : 5079 SHIELDS RD
Second Line :
City : LEWISBURG
State : OH
Zip : 45338-8008
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 948 PATTERSON RD
Second Line :
City : DAYTON
State : OH
Zip : 45419-4336
Country : US
Telephone Number : 937-660-4145
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2025
Last Update Date : 12/12/2025

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Directions to “ BROOKLYN JOHNSON ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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