Cris William Johnston, PH.D.

Individual provider Active NPI Clinical Neuropsychologist · Prescott, WI

NPI 1174512644 · NPPES record last updated Jul 13, 2026

Key facts

NPI
1174512644
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Neuropsychologist 103G00000X
License
2470-057 (WI)
Practice address
115 Orange St
Prescott, WI 54021-1728
Phone
(715) 262-5559
NPI assigned
Oct 18, 2005
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LP 0160MNMDClinical Neuropsychologist
2470-057WIMDClinical Neuropsychologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 2470-057 WI Yes
Clinical Neuropsychologist 103G00000X LP 0160 MN

Addresses

Primary practice location

115 Orange St
Prescott, WI 54021-1728

Mailing address

W9722 290TH Ave
Hager City, WI 54014-8349
Phone (715) 262-5559

Other providers in Prescott, WI

All providers in Prescott, WI · Clinical Neuropsychologist in Wisconsin

Sources for this page

Verify at the official NPI Registry.