Active NPI
Devyn Johnston, TLLP
- Clinical Psychologist
- Rochester, MI
National Provider Identifier
1437761632
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6362009598
- Practice address
- 1135 Walton Blvd
Suite 445
Rochester, MI 48307 - Phone
- (248) 413-5027
- NPI assigned
- Aug 19, 2020
- Reactivated
- Jan 25, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6362009598 | MI | Primary |
Addresses
Primary practice location
1135 Walton Blvd
Suite 445
Rochester, MI 48307
Mailing address
1135 Walton Blvd
Suite 445
Rochester, MI 48307
Phone (248) 413-5027
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6362009598 | MI | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alliance Psychological Services | Clinical | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinical Psychologist
- Rochester, MI
- NPI 1639558620
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678665600000",
"number": "1437761632",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1135 WALTON BLVD",
"address_2": "SUITE 445",
"city": "ROCHESTER",
"state": "MI",
"postal_code": "48307",
"telephone_number": "248-413-5027"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1135 WALTON BLVD",
"address_2": "SUITE 445",
"city": "ROCHESTER",
"state": "MI",
"postal_code": "48307",
"telephone_number": "248-413-5027"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSTON",
"first_name": "DEVYN",
"credential": "TLLP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-08-19",
"last_updated": "2023-03-13",
"certification_date": "2023-02-09",
"deactivation_date": "2023-01-04",
"reactivation_date": "2023-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6362009598",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rochester, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.