Provider Demographics
NPI:1679452338
Name:JOHNSON, D'SHAE MIKAYLA
Entity type:Individual
Prefix:MISS
First Name:D'SHAE
Middle Name:MIKAYLA
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 WILLIAM HOWARD TAFT RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2753
Mailing Address - Country:US
Mailing Address - Phone:937-708-9707
Mailing Address - Fax:937-708-9707
Practice Address - Street 1:7373 BROOKCREST DR STE 354
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45237-3448
Practice Address - Country:US
Practice Address - Phone:937-708-9707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-28
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2504457-TRNE104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker