Susanne Johnson, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071006253 Issued in IL

Practice address

728 Ogden Ave
Ste E
Downers Grove, IL 60515-2901

Phone

(630) 640-2980

NPI assigned

Aug 1, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

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.

• Davken Associates, P.C.

  • Clinical Psychologist
  • Deerfield, IL
  • NPI 1457393159
  NPD (past)
• Jennifer Logston Counseling LTD

  • Clinical Social Worker
  • Downers Grove, IL
  • NPI 1548706005
  NPD (past)
• Mosaic Mind Counseling LLC

  • Clinical Social Worker
  • Downers Grove, IL
  • NPI 1235781253
  NPD (past)

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462924800000",
    "number": "1144237488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "728 OGDEN AVE",
            "address_2": "STE E",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605152901",
            "telephone_number": "630-640-2980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "728 OGDEN AVE",
            "address_2": "STE E",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605152901",
            "telephone_number": "630-640-2980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SUSANNE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2016-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071006253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN BEHAVIORAL HEALT",
            "identifier": "IP558185",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSSBLUESHIELD",
            "identifier": "2227588",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaija Marie Johnson
• Pamela Jean Johnson, MA, LCPC, DAPA
• Sarah Carlota Johnson, P.A.
• Sarah Nicole Johnson, RDH
• Sonji Johnson
• Valerie E Johnson, PH.D., CCC-SLP
• Victoria Johnson
• Kristy Johnstone, LCSW
• Joliet Oncology Hematology Associates LTD
• Jeanice D Jones, FNP-BC

• Clinical Psychologist in Downers Grove, IL
• Providers in Downers Grove, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.