Angelina Maria Johnson, PSY.D., LP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY.0004555 Issued in CO

Practice address

1259 Lake Plaza Dr Ste 255
Colorado Springs, CO 80906-3504

Phone

(719) 598-3585

NPI assigned

Nov 25, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

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

Specialty

Clinical Psychologist

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pickett Psychological Services LLCGroup PAC ID 0840698882, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Pickett Psychological Services, LLC

  dba Central Focus Psychological Group

  • Clinical Psychologist
  • Colorado Springs, CO
  • NPI 1598434300
  Medicare reassignment Care Compare group NPD
• Pickett Psychological Services, LLC

  dba Central Focus Psychological Group

  • Clinical Psychologist
  • Lakewood, CO
  • NPI 1871481549
  NPD

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

{
    "created_epoch": "1385337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1487084695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1259 LAKE PLAZA DR STE 255",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809063504",
            "telephone_number": "719-598-3585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1259 LAKE PLAZA DR STE 255",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809063504",
            "telephone_number": "719-598-3585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ANGELINA",
        "middle_name": "MARIA",
        "credential": "PSY.D., LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-25",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KS",
            "license": "T-LP 2182",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "PSY.0004555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Johnson, RBT
• Amber Johnson
• Amy Marie Johnson, NNP BC, RN
• Andrea S Johnson
• Andrew Johnson
• Anna Johnson, LPCC
• Anna Johnson
• Arilyn Johnson
• Barbara J Johnson, MSW
• Blake Johnson

• Clinical Psychologist in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Clinical Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.