Individual provider Active NPI

Benjamin Norman Johnson, PHD

  • Clinical Psychologist
  • Hackensack, NJ
National Provider Identifier
1396590170
Registry record updated May 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
35SI00743800 Issued in NJ
Practice address
131 Temple Ave
Hackensack, NJ 07601-6008
Phone
(678) 313-2448
NPI assigned
Apr 23, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 35SI00743800 NJ Primary

Addresses

Primary practice location

131 Temple Ave
Hackensack, NJ 07601-6008

Mailing address

6911 Yellowstone Blvd Apt B2
Forest Hills, NY 11375-3715
Phone (678) 313-2448

Other practice location 1

1 University Plz Ste 618
Hackensack, NJ 07601-6236
Phone (201) 487-4298

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
35SI00743800NJMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercedes a. Paine, MD, PC Past Accepting new patients
The Center for Integrative Psychiatry & Counseling Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1713830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1396590170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6911 YELLOWSTONE BLVD APT B2",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113753715",
            "telephone_number": "678-313-2448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 TEMPLE AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076016008",
            "telephone_number": "678-313-2448"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 University Plz Ste 618",
            "address_purpose": "LOCATION",
            "city": "Hackensack",
            "state": "NJ",
            "postal_code": "076016236",
            "country_code": "US",
            "telephone_number": "201-487-4298",
            "fax_number": "201-487-6110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BENJAMIN",
        "middle_name": "NORMAN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-23",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00743800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; 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.