Velisa Marie Johnson, PHD, ABPP-CN

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

6301016552 Issued in MI

Practice address

5030 Corporate Exchange Blvd SE Ste 201
Grand Rapids, MI 49512-5506

Phone

(616) 287-4164

NPI assigned

Feb 14, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

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

Locations

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.

• Westside Neuropsychology, PLLC

  • Clinical Neuropsychologist
  • Grand Rapids, MI
  • NPI 1417848763
  NPD Authorized official

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

{
    "created_epoch": "1202947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769990400000",
    "number": "1184892952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5030 CORPORATE EXCHANGE BLVD SE STE 201",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495125506",
            "telephone_number": "616-287-4164",
            "fax_number": "616-419-8412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5030 CORPORATE EXCHANGE BLVD SE STE 201",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495125506",
            "telephone_number": "616-287-4164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "VELISA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PHD, ABPP-CN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-14",
        "last_updated": "2026-02-02",
        "certification_date": "2026-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MI",
            "license": "6301016552",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "36373",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "HI",
            "license": "PSY-2300-0",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Bryn Johnson
• Taylor Marie Johnson, LMT
• Terry Lynn Johnson
• Todd Johnson
• Travis Roland Johnson
• Dallas Dominique Johnston, PA
• Jennifer Elaine Johnston, M.D.
• Kristine Johnston
• Rachiel Abul Atem Jok
• Ashley Dominque Joldersma, PA-C

• Clinical Neuropsychologist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Clinical Neuropsychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2026; 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.