MEDICARE: CHELSEA SUZANNE JOHNSON LLMSW

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	6801120182	MI
2	104100000X	Social Worker	6801120182	MI

General Provider Information

NPI Number	:	1528723731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHELSEA SUZANNE JOHNSON LLMSW

Provider Business Mailing Address
First Line	:	1 FORD PL STE 3A
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48202-3450
Country	:	US
Telephone Number	:	313-874-4806
Fax Number	:	313-876-1305

Provider Business Practice Location Address
First Line	:	6777 W MAPLE RD
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48322-3013
Country	:	US
Telephone Number	:	248-661-6100
Fax Number	:

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

Provider Enumeration Date	:	11/02/2021
Last Update Date	:	01/22/2026

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