MARCUS TYRONE JOHNSON NPI 1922880145

NPI Information

  • NPI: 1922880145
  • Provider Name: MARCUS TYRONE JOHNSON
  • Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
  • Entity Type: Individual
  • Address: 6226 HEATHER GLEN DR
    SUFFOLK, VA
    ZIP 23435
  • Phone: (757) 374-1741

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NPI Details

Marcus Tyrone Johnson is a community based residential treatment facility, intellectual and/or developmental disabilities in Suffolk, VA. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. Marcus Tyrone Johnson NPI is 1922880145. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

6226 HEATHER GLEN DR
SUFFOLK, VA
ZIP 23435-133
Phone: (757) 374-1741

The enumeration date for this NPI number is 10/23/2023 and was last updated on 10/23/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1320900000XCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities7924VIRGINIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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