Michael Dean Johnson, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

30562 Issued in TX

Practice address

14740 Barryknoll LN
Suite 130
Houston, TX 77079

Phone

(281) 679-0333

Fax

(281) 679-6545

NPI assigned

Nov 17, 2006

Last updated

Jun 19, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Shiloh Treatment Center, Inc.

  • Psychiatric Residential Treatment Facility
  • Manvel, TX
  • NPI 1992877948
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529366400000",
    "number": "1063585784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14740 BARRYKNOLL LN",
            "address_2": "SUITE 130",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770792884",
            "telephone_number": "281-679-0333",
            "fax_number": "281-679-6545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14740 BARRYKNOLL LN",
            "address_2": "SUITE 130",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77079",
            "telephone_number": "281-679-0333",
            "fax_number": "281-679-6545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MICHAEL",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2018-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "30562",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "30562",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149851101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0004GD",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "231238",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marysa Johnson
• Melanie Johnson, LMSW
• Melanie Johnson, NP-C
• Melissa D Johnson, COTA
• Mia Johnson
• Michelle Johnson
• Michelle Y Johnson
• Monetra Johnson, PA-C
• Monique Johnson, LPC
• Monique C. Johnson

• Clinical Psychologist in Houston, TX
• Providers in Houston, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.

Verify at the official NPI Registry.