Victoria Lecorian Johnson, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

EMC0002347 Issued in MI

Practice address

804 Fairview LN Apt 2
Fort Lee, NJ 07024-1568

Phone

(478) 719-7682

Fax

(551) 236-2513

NPI assigned

Jun 8, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 10

Addresses

Other names 1

• Victoria L Johnson- Rivers Other name

Medicare fee-for-service enrollment

Enrolled in NY, IL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/tfcc/r4/

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

• County of Lake

  • Public Health or Welfare Agency
  • Waukegan, IL
  • NPI 1013920750
  Medicare reassignment NPD
• Valera Medical, P.C.

  • Psychiatry Physician
  • Brooklyn, NY
  • NPI 1437782349
  Medicare reassignment
• County of Lake

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waukegan, IL
  • NPI 1568674836
  NPD
• County of Lake

  • Federally Qualified Health Center (FQHC)
  • Round Lake, IL
  • NPI 1639588254
  NPD
• Tillamook Family Counseling Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Tillamook, OR
  • NPI 1063623478
  NPD (past)
• Tillamook Family Counseling Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tillamook, OR
  • NPI 1659380145
  NPD (past)

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

{
    "created_epoch": "1433721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760227200000",
    "number": "1083094791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 FAIRVIEW LN APT 2",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070241568",
            "telephone_number": "478-719-7682",
            "fax_number": "551-236-2513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 FAIRVIEW LN APT 2",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070241568",
            "telephone_number": "478-719-7682",
            "fax_number": "551-236-2513"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15100 Mack Ave",
            "address_purpose": "LOCATION",
            "city": "Grosse Pointe Park",
            "state": "MI",
            "postal_code": "482306202",
            "country_code": "US",
            "telephone_number": "313-824-4400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "725 Welch Rd",
            "address_purpose": "LOCATION",
            "city": "Palo Alto",
            "state": "CA",
            "postal_code": "943041601",
            "country_code": "US",
            "telephone_number": "650-497-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "906 Main Ave",
            "address_purpose": "LOCATION",
            "city": "Tillamook",
            "state": "OR",
            "postal_code": "971413816",
            "country_code": "US",
            "telephone_number": "503-842-8201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "VICTORIA",
        "middle_name": "LECORIAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-08",
        "last_updated": "2025-10-12",
        "certification_date": "2025-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AL",
            "license": "35571",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A184505",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA11645700",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "EMC0002347",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "OR",
            "license": "MD223582",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "303597",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MI",
            "license": "EMC0002347",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "A184505",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "303597",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "93593",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICTORIA",
            "last_name": "JOHNSON- RIVERS",
            "middle_name": "L",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Child & Adolescent Psychiatry Physician in Fort Lee, NJ
• Providers in Fort Lee, NJ by specialty
• Child & Adolescent Psychiatry Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.