Robert Eric Johnson, PH.D.
Individual provider Active NPI Clinical Psychologist · Forest Hill, TX
NPI 1306037445 · NPPES record last updated May 28, 2021
Key facts
- NPI
- 1306037445
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PY61114622 (WA)
- Practice address
- 3150 Horton Rd
Forest Hill, TX 76119-5905 - Phone
- (817) 413-3274
- NPI assigned
- Aug 5, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- U S Health Dept of Health and Human Services
Practice addresses (Care Compare)
107 H St
P O Box 67
Poplar, MT 59255-0067
107 H St E
P O Box 67
Poplar, MT 59255-0067
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WA, TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210615000888 | WA | Practitioner - Clinical Psychologist | 5395145288 | Reassigns benefits to 1 organization |
| I20240212002020 | TX | Practitioner - Clinical Psychologist | 5395145288 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY61114622 | WA | MD | Clinical Psychologist |
| 1981 | WI | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Federal Correctional Institution | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY61114622 | WA | Yes |
| Psychologist | 103T00000X | 1981 | WI |
Addresses
Primary practice location
3150 Horton Rd
Forest Hill, TX 76119-5905
Mailing address
3150 Horton Rd
Forest Hill, TX 76119-5905
Phone (817) 413-3274
Other names
- Dr. Daniel Kim
Other providers in Forest Hill, TX
- Anthony Hoang
- Impressive Hands LLC
- Inspired Divinely Health Care, LLC
- Jehoram Christian Outreach Ministries
- Jeremy Simmons, PLLC
- Olutoyin Ezekiel Makinde
- Bryana M Martin
- Omolara Madinat Medaiyese
- Stephanie Ifeoma Menes
- Ali Moshtaghfard
All providers in Forest Hill, TX · Clinical Psychologist in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 28, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.