Candace S Johnson, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6619 Issued in OH

Practice address

6404 Thornberry CT
Suite 430
Mason, OH 45040-3502

Phone

(513) 229-7585

Fax

(513) 229-7731

NPI assigned

Jun 6, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

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 and National Provider Directory roles.

• Professional Psychiatric Services, LLC

  • Psychiatry Physician
  • West Chester, OH
  • NPI 1538115092
  NPD (past)

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

{
    "created_epoch": "1307318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307318400000",
    "number": "1215221486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6404 THORNBERRY CT",
            "address_2": "SUITE 430",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450403502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6404 THORNBERRY CT",
            "address_2": "SUITE 430",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450403502",
            "telephone_number": "513-229-7585",
            "fax_number": "513-229-7731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CANDACE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-06",
        "last_updated": "2011-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "6619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyler Anthony Jewell, BS,CNIM
• Jewish Home of Cincinnati, Inc. (Cedar Village)
• Jewish Home of Cincinnati, Inc. (Cedar Village Home Care)
• Kimberly Ann Joest, ATC
• Bernadette Rosina Johns, EDD
• Danielle J Johnson, MD
• Emilie Doyle Johnson, MA CCC SLP
• Kylie Johnson
• Sabrina Johnson, RN
• Whitney Johnson

• Clinical Psychologist in Mason, OH
• Providers in Mason, OH by specialty
• Clinical Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2011; 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.