Healthcare Provider Details

I. General information

NPI: 1942846977
Provider Name (Legal Business Name): CHARNITA JOHNSON LLMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHARNITA PARKER

II. Dates (important events)

Enumeration Date: 11/25/2019
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

882 OAKMAN BLVD
DETROIT MI
48238-3710
US

IV. Provider business mailing address

20051 DELAWARE AVE
REDFORD MI
48240-1158
US

V. Phone/Fax

Practice location:
  • Phone: 313-961-4890
  • Fax:
Mailing address:
  • Phone: 313-740-4163
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6851115217
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: