Active NPI
Brianna Johnson
- Clinical Psychologist
- West Lafayette, IN
National Provider Identifier
1013415033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 20043078A
- Practice address
- 601 Stadium Mall Drive
Purdue University Student Health Center, 2ND Floor
West Lafayette, IN 47907 - Phone
- (765) 494-6995
- NPI assigned
- Jan 24, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 20043078A | IN | Primary |
Addresses
Primary practice location
601 Stadium Mall Drive
Purdue University Student Health Center, 2ND Floor
West Lafayette, IN 47907
Mailing address
601 Stadium Mall Drive
Purdue University Student Health Center, 2ND Floor
West Lafayette, IN 47907
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20043078A | IN | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516752000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1516752000000",
"number": "1013415033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 STADIUM MALL DRIVE",
"address_2": "PURDUE UNIVERSITY STUDENT HEALTH CENTER, 2ND FLOOR",
"city": "WEST LAFAYETTE",
"state": "IN",
"postal_code": "47907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 STADIUM MALL DRIVE",
"address_2": "PURDUE UNIVERSITY STUDENT HEALTH CENTER, 2ND FLOOR",
"city": "WEST LAFAYETTE",
"state": "IN",
"postal_code": "47907",
"telephone_number": "765-494-6995"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "BRIANNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-24",
"last_updated": "2018-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IN",
"license": "20043078A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Lafayette, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.