Healthcare Provider Details

I. General information

NPI: 1023943818
Provider Name (Legal Business Name): EM JOHNSON MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3417 14TH ST NW
WASHINGTON DC
20010-3402
US

IV. Provider business mailing address

3417 14TH ST NW
WASHINGTON DC
20010-3402
US

V. Phone/Fax

Practice location:
  • Phone: 301-857-9333
  • Fax: 301-245-2733
Mailing address:
  • Phone: 301-857-9333
  • Fax: 301-245-2733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ELLYN MARIE JOHNSON
Title or Position: PRESIDENT
Credential: MD
Phone: 301-857-9333