MEDICARE: SYLVIA ROSE 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	1041C0700X	Clinical Social Worker	6801099459	MI

General Provider Information

NPI Number	:	1104317171
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYLVIA ROSE JOHNSON

Provider Business Mailing Address
First Line	:	21611 E 11 MILE RD
Second Line	:
City	:	SAINT CLAIR SHORES
State	:	MI
Zip	:	48081-1636
Country	:	US
Telephone Number	:	586-944-2902
Fax Number	:	586-944-2903

Provider Business Practice Location Address
First Line	:	21611 E 11 MILE RD
Second Line	:
City	:	SAINT CLAIR SHORES
State	:	MI
Zip	:	48081-1636
Country	:	US
Telephone Number	:	248-330-5770
Fax Number	:

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

Provider Enumeration Date	:	05/24/2018
Last Update Date	:	05/06/2026

Similar Medicare Providers

1518591932 — MICHIGAN CENTER FOR TRAUMATIC STRESS
Practice Location Address:

21611 E 11 MILE RD
SAINT CLAIR SHORES, MI
48081-1636

Practice Phone: 586-944-2902
Practice Fax:

1861439457 — MR. DAVID JASON SCHWARTZ M.A.
Practice Location Address:

21611 E 11 MILE RD
SAINT CLAIR SHORES, MI
48081-1636

Practice Phone: 586-944-2902
Practice Fax:

1124400932 — NICOLE MARIE GREEN LMSW
Practice Location Address:

21611 E 11 MILE RD STE A
SAINT CLAIR SHORES, MI
48081-1636

Practice Phone: 586-944-2902
Practice Fax:

1033174636 — JOHN LLOYD ZINKEL MD, PHD
Practice Location Address:

21605 E 11 MILE RD
ST CLAIR SHORES, MI
48081-1636

Practice Phone: 586-774-4600
Practice Fax: 586-774-4603

1750300679 — MARCUS E KOSS M.D.
Practice Location Address:

21603 E 11 MILE RD
SAINT CLAIR SHORES, MI
48081-1636

Practice Phone: 586-280-2100
Practice Fax: 586-210-8808

1932381571 — JOHN L. ZINKEL MD, PC
Practice Location Address:

21605 E 11 MILE RD
SAINT CLAIR SHORES, MI
48081-1636

Practice Phone: 586-774-4600
Practice Fax: 586-774-4603

Directions to “ SYLVIA ROSE JOHNSON ” Practice Location

Language	Start Address	Practice Location

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.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.