DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: AUDREY JEAN JOHNSON

MEDICARE: AUDREY JEAN 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
1104100000XSocial Worker

General Provider Information

NPI Number : 1528751054
Entity Type Code : Individual
Provider Name (Legal Business Name) : AUDREY JEAN JOHNSON
Provider Business Mailing Address
First Line : 3300 36TH ST SE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49512-2810
Country : US
Telephone Number : 616-942-2110
Fax Number :
Provider Business Practice Location Address
First Line : 1111 40TH ST SE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49508-6084
Country : US
Telephone Number : 616-241-6258
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2023
Last Update Date : 03/12/2026

Similar Medicare Providers

1346665858 — MELISSA FISK B.S.W., Q.I.D.P.
Practice Location Address:
1111 40TH ST SE
GRAND RAPIDS, MI
49508-6084
Practice Phone: 616-889-1607
Practice Fax: 616-241-6470
1386017499 — STEPHANIE EXTON MS
Practice Location Address:
1111 40TH ST SE
GRAND RAPIDS, MI
49508-6084
Practice Phone: 616-885-8078
Practice Fax: 616-885-8078
1952854804 — LUCIANA LABOZZETTA
Practice Location Address:
1111 40TH ST SE
GRAND RAPIDS, MI
49508-6084
Practice Phone: 616-516-8990
Practice Fax:
1750826723 — MORGAN WISE
Practice Location Address:
1111 40TH ST SE
GRAND RAPIDS, MI
49508-6084
Practice Phone: 616-241-6258
Practice Fax:
1790210771 — MS. VERONICA CELIA SANTOS FUENTES B.A
Practice Location Address:
1111 40TH ST SE
GRAND RAPIDS, MI
49508-6084
Practice Phone: 616-617-3552
Practice Fax: 616-241-6470
1922518133 — MS. KAITLIN KATHLEEN GENSLAK
Practice Location Address:
1111 40TH ST SE
GRAND RAPIDS, MI
49508-6084
Practice Phone: 616-827-4187
Practice Fax:

Directions to “ AUDREY JEAN 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.