DORETTE L JOHNSON (NPI# 1780135780) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1780135780 |
Entity Type | Individual |
Full Name | DORETTE L JOHNSON |
Credential | CDCA |
Practice Address |
1711 Spring Ave Ne Canton OH 44714-2349 |
Mailing Address |
625 Cleveland Ave Nw Canton OH 44702-1805 |
Practice Telephone | 3304546800 |
Practice Fax Number | 3305887176 |
Mailing Telephone | 3304538252 |
Mailing Fax Number | 3304536716 |
Enumeration Date | 2016-10-14 |
Last Update Date | 2019-09-26 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
CDCA.150089 | OH | Behavioral Health & Social Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OH | 0265988 | 05 |
Street Address |
1711 SPRING AVE NE |
City | CANTON |
State | OH |
Zip Code | 44714-2349 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710936901 | Quest Recovery and Prevention Services | Substance Abuse Rehabilitation Facility | 1711 Spring Ave Ne, Canton, OH 44714-2349 | 2006-05-08 |
1508497561 | Melissa Nicole Saunders | Counselor | 1711 Spring Ave Ne, Canton, OH 44714-2349 | 2020-01-29 |
1588295620 | Kimberly B Tucker-pettay | Counselor | 1711 Spring Ave Ne, Canton, OH 44714-2349 | 2020-01-28 |
1760013874 | Tammy D Williams | Counselor | 1711 Spring Ave Ne, Canton, OH 44714-2349 | 2020-01-28 |
1144790940 | Jennifer Ann Bigrigg | Social Worker | 1711 Spring Ave Ne, Canton, OH 44714-2349 | 2018-12-05 |
1336626555 | Kristina Marie Zeren | Counselor | 1711 Spring Ave Ne, Canton, OH 44714-2349 | 2018-07-20 |
1164910451 | Therese Anne Sedon | Counselor | 1711 Spring Ave Ne, Canton, OH 44714-2349 | 2018-04-23 |
1790298172 | Breana R Mitchell | Counselor | 1711 Spring Ave Ne, Canton, OH 44714-2349 | 2017-11-08 |
1447790720 | Teresa Millard | Counselor | 1711 Spring Ave Ne, Canton, OH 44714-2349 | 2017-03-06 |
1851759229 | Michelle M Smith | Counselor | 1711 Spring Ave Ne, Canton, OH 44714-2349 | 2016-02-01 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164941365 | Desiree Morgan | Occupational Therapy Assistant | 1634 20th St. N.e., Canton, OH 44714 | 2017-09-19 |
1932525706 | Cody Henninge | In Home Supportive Care | 2800 Market Ave N Suite 16, Canton, OH 44714 | 2014-03-17 |
1346584984 | Quest Recovery and Prevention Services | Substance Abuse Rehabilitation Facility | 1711 Spring Avenue Nw, Canton, OH 44714 | 2012-11-20 |
1780159921 | Lynne Marie Shayko | Counselor | 1341 Market Ave N, Canton, OH 44714 | 2018-10-03 |
1427437540 | Robert D Cox | Counselor | 1341 Market Ave N, Canton, OH 44714 | 2015-05-21 |
1225435969 | Emily A Custer | Counselor | 1341 Market Ave N, Canton, OH 44714 | 2014-11-24 |
1700438363 | Ryan Gernert | Specialist/Technologist | 5323 Gardendale Ave Ne, Canton, OH 44714-1042 | 2019-07-14 |
1982171468 | Adrienne Chavers | Home Health | 5438 Market Ave N, Canton, OH 44714-1059 | 2018-11-01 |
1912061797 | Living 4 Independence | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4629 Helmsworth Dr Ne, Canton, OH 44714-1162 | 2006-12-19 |
1114306412 | Haydee Thomas | Registered Nurse | 4611 Lindenwood Ave Ne, Canton, OH 44714-1169 | 2015-05-20 |
Find all providers in zip 44714 |
Taxonomy Code | 101YA0400X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Addiction (Substance Use Disorder) |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851904890 | Aurora Health Services LLC | Counselor | 200 6th Street Nw, Canton, OH 44702-1005 | 2020-08-28 |
1942819032 | Restoration Community Services LLC | Counselor | 831 Market Ave N, Canton, OH 44702-1175 | 2020-07-24 |
1619590882 | A.v.o Behavioral Health LLC | Counselor | 3745 Whipple Ave Nw Ste A, Canton, OH 44718-4805 | 2020-05-22 |
1356976930 | Nadine Blase Psareas | Counselor | 1558 Marietta Hwy Ste 200, Canton, GA 30114-3615 | 2020-03-04 |
1245870591 | Adriane Everett | Counselor | 906 12 St Nw, Canton, OH 44703 | 2020-01-14 |
1770123812 | Kelly Wells | Counselor | 906 12th St Nw, Canton, OH 44703-1902 | 2020-01-07 |
1528601663 | Shelly R Bowling | Counselor | 1522 Baum St Se, Canton, OH 44707-1107 | 2019-10-22 |
1962043141 | Erin Ann Williams | Counselor | 1023 S Trade Days Blvd Unit 102, Canton, TX 75103-2434 | 2019-09-30 |
1346898079 | Shericka Meeks | Counselor | 304 15th St Ne Ste B, Canton, OH 44714-2523 | 2019-08-27 |
1295293876 | Diamond Lawrencethia Gay | Counselor | 4661 Belpar St Nw, Canton, OH 44718-3602 | 2019-03-04 |
Find all providers in CANTON |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.