Provider Demographics
NPI:1053755728
Name:JOHNSON, ERINN MARTINE (LMSW)
Entity type:Individual
Prefix:MRS
First Name:ERINN
Middle Name:MARTINE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MRS
Other - First Name:ERINN
Other - Middle Name:MARTINE
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CAADC
Mailing Address - Street 1:1114 OAK VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48341-2358
Mailing Address - Country:US
Mailing Address - Phone:248-332-9395
Mailing Address - Fax:
Practice Address - Street 1:1114 OAK VALLEY DR
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341-2358
Practice Address - Country:US
Practice Address - Phone:248-332-9395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-24
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010898451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical