MEDICARE: ACACIA LA DAWN 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
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1548116189
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ACACIA LA DAWN JOHNSON

Provider Business Mailing Address
First Line	:	3645 RIDGE MILL DR
Second Line	:
City	:	HILLIARD
State	:	OH
Zip	:	43026-7752
Country	:	US
Telephone Number	:	614-457-7876
Fax Number	:	614-457-7876

Provider Business Practice Location Address
First Line	:	3645 RIDGE MILL DR
Second Line	:
City	:	HILLIARD
State	:	OH
Zip	:	43026-7752
Country	:	US
Telephone Number	:	614-457-7876
Fax Number	:	614-457-7876

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2026
Last Update Date	:	03/06/2026

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Directions to “ ACACIA LA DAWN JOHNSON ” Practice Location

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