Healthcare Provider Details

I. General information

NPI: 1720753668
Provider Name (Legal Business Name): JOHNNA LAWSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2021
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27777 INKSTER RD STE 100
FARMINGTON HILLS MI
48334-5312
US

IV. Provider business mailing address

27777 INKSTER RD STE 100
FARMINGTON HILLS MI
48334-5312
US

V. Phone/Fax

Practice location:
  • Phone: 248-436-4400
  • Fax:
Mailing address:
  • Phone: 248-436-4400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCTE-2025-0851
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCTE-2025-0196
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: