Jacqlyn Dawn Johnson, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY1001330 Issued in DC

Practice address

1350 Connecticut Ave NW Ste 612
Washington, DC 20036-1735

Phone

(202) 495-1581

NPI assigned

Dec 28, 2017

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 18, 2021 through Jan 18, 2027

Medicare enrollment (NPD)

Not enrolled

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.

• J. Dawn Johnson, PSYD, PLLC

  • Mental Health Counselor
  • Washington, DC
  • NPI 1861036196
  NPD Authorized official

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

{
    "created_epoch": "1514419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514419200000",
    "number": "1225544224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1629 FRANCIS HAMMOND PKWY",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223023915",
            "telephone_number": "202-495-1581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 CONNECTICUT AVE NW STE 612",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200361735",
            "telephone_number": "202-495-1581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JACQLYN",
        "middle_name": "DAWN",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-28",
        "last_updated": "2017-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "DC",
            "license": "PSY1001330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Imani Janelle Johnson
• India Lashae Johnson
• Isaiah David Johnson
• Iyanah Johnson
• Ja'Kiya M Johnson
• Jade Johnson
• Jaidyn Johnson
• Jamarr Joshua Alphonse Johnson
• James Edward Johnson, DDS
• Janaya Toya Johnson, PCA

• Clinical Psychologist in Washington, DC
• Providers in Washington, DC by specialty
• Clinical Psychologist in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.