MR. RUDOLPH JOHNSON (NPI# 1609096767) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609096767 |
| Entity Type | Individual |
| Full Name | MR. RUDOLPH JOHNSON |
| Credential | LMSW |
| Practice Address |
4925 Packard St Ann Arbor MI 48108-1521 |
| Mailing Address |
1996 Clairmount St Detroit MI 48206-2017 |
| Practice Telephone | 7349719781 |
| Practice Fax Number | 7349712730 |
| Mailing Telephone | 3133307982 |
| Mailing Fax Number | 3138988027 |
| Enumeration Date | 2007-04-30 |
| Last Update Date | 2008-02-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
6801073825 | MI | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124579545 | Rudolph Johnson Jr. | Substance Abuse Rehabilitation Facility | 6537 Reflection Dr Apt 105, San Diego, CA 92124-3111 | 2016-10-20 |
| 1811903511 | Rudolph Johnson Jr. | Nurse Anesthetist, Certified Registered | 1400 Us Highway 61, Festus, MO 63028-4100 | 2006-08-01 |
| Street Address |
4925 PACKARD ST |
| City | ANN ARBOR |
| State | MI |
| Zip Code | 48108-1521 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679687339 | Catholic Social Services of Washtenaw County | Voluntary or Charitable | 4925 Packard St, Ann Arbor, MI 48108-1521 | 2006-08-19 |
| 1689275091 | Rosalee Washington | Social Worker | 4925 Packard St, Ann Arbor, MI 48108-1521 | 2020-11-03 |
| 1003424433 | Edward Baik | Social Worker | 4925 Packard St, Ann Arbor, MI 48108-1521 | 2020-07-22 |
| 1134752827 | Virginia Willey | Social Worker | 4925 Packard St, Ann Arbor, MI 48108-1521 | 2020-02-20 |
| 1457858490 | Manuela Uribe | Social Worker | 4925 Packard St, Ann Arbor, MI 48108-1521 | 2018-04-06 |
| 1649774902 | Cristina M Raphaela Luzio De Moeller | Social Worker | 4925 Packard St, Ann Arbor, MI 48108-1521 | 2018-03-21 |
| 1922516855 | Glenn Jefferson Spaulding | Social Worker | 4925 Packard St, Ann Arbor, MI 48108-1521 | 2018-01-12 |
| 1265945307 | Christa Marie Hughbanks | Social Worker | 4925 Packard St, Ann Arbor, MI 48108-1521 | 2017-11-11 |
| 1568980704 | Lori Klein-shapiro | Social Worker | 4925 Packard St, Ann Arbor, MI 48108-1521 | 2017-09-08 |
| 1225568009 | Marna M Clowney-robinson | Social Worker | 4925 Packard St, Ann Arbor, MI 48108-1521 | 2017-06-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750999249 | Creating Brighter Futures | Behavioral Analyst | 4201 Varsity Drive, Ste. C, Ann Arbor, MI 48108 | 2020-07-21 |
| 1326506320 | Michelle Bishop | Behavior Technician | 4935 Birch Hollow Dr, Ann Arbor, MI 48108 | 2019-03-08 |
| 1407326077 | Alexis Ewald | Behavior Technician | 2770 Carpenter Rd., Ann Arbor, MI 48108 | 2018-11-27 |
| 1003308511 | Ann Arbor Dental Specialists | Dentist | 3100 Eisenhower Parkway, Suite 200, Ann Arbor, MI 48108 | 2018-05-31 |
| 1144719295 | Jonathan Parker Etter | Physical Medicine & Rehabilitation | 325 E. Eisenhower, Suite 300, Spc 5744, Ann Arbor, MI 48108 | 2018-05-04 |
| 1427555895 | Blossom Health Services LLC | Social Worker | 2156 Glencoe Hills Dr Apt 12, Ann Arbor, MI 48108 | 2018-04-11 |
| 1669974580 | Camron Anthony Moorehead | Occupational Therapist | 400 E. Eisenhower Parkway Bldg 2, Ste A, Ann Arbor, MI 48108 | 2018-03-07 |
| 1396247862 | Crystal Ann D'agostino | Health Educator | 1169 Oak Valley Drive, Ann Arbor, MI 48108 | 2018-03-01 |
| 1538671250 | Miea Moon | Psychologist | 3200 E Eisenhower Parkway, Moriah Hall, Ann Arbor, MI 48108 | 2017-11-03 |
| 1003355546 | Rachael Connolly | Behavior Technician | 4201 Varsity Drive Suite C, Ann Arbor, MI 48108 | 2017-02-16 |
| Find all providers in zip 48108 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801344908 | Matthew Statman | Counselor | 1705 Pontiac Trl, Ann Arbor, MI 48105-1722 | 2016-09-17 |
| 1063831501 | Jill Kent | Counselor | 502 W Huron St, Ann Arbor, MI 48103-4208 | 2014-04-14 |
| 1003180878 | Robin Dawn Edison | Counselor | 5656 Le Blanc Ave, Ann Arbor, MI 48103-9394 | 2012-02-27 |
| 1376536367 | Sandra Lea Samons | Counselor | 1480 Shevchenko Dr, Ann Arbor, MI 48103-9001 | 2005-08-25 |
| 1043811656 | Taylor Bechard | Counselor | 502 W Huron St, Ann Arbor, MI 48103-4208 | 2020-11-02 |
| 1851933741 | Theodore Heaton | Counselor | 315 N Main St, Ann Arbor, MI 48104-1133 | 2019-10-11 |
| 1801396874 | Jillian Marie Rizk | Counselor | 522 S Maple Rd, Ann Arbor, MI 48103-3837 | 2018-02-16 |
| 1992213995 | Megan Elizabeth Sanford | Counselor | 320 Miller Ave Ste 100, Ann Arbor, MI 48103-3385 | 2018-01-12 |
| 1649784448 | John N Worthy | Counselor | 320 Miller Ave Ste 100, Ann Arbor, MI 48103-3385 | 2017-12-01 |
| 1992219497 | Tiffany Schultz | Counselor | 2010 Hogback Rd Ste 6g, Ann Arbor, MI 48105-8800 | 2017-11-21 |
| Find all providers in ANN ARBOR | ||||
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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.