Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Marcus Tyrone Johnson

Individual provider Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · NPI 1922880145

Marcus Tyrone Johnson is an Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Suffolk, Virginia. Practices as a sole proprietor. Licensed in Virginia.

Licensed in
VA
In the registry since
2023
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Practice location Address checks out

6226 Heather Glen Dr
Suffolk, VA 23435-3133
Phone: (757) 374-1741
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (primary) Taxonomy 320900000X · Licence 7924 (VA)

Record details

NPI number1922880145
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedOctober 23, 2023
Last updated in NPPESOctober 23, 2023
Certification dateOctober 21, 2023
Mailing address6226 Heather Glen Dr, Suffolk, VA 23435-3133

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