Christina Lynne Johnson, M.A., L.L.P.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301013793 Issued in MI

Practice address

47818 Van Dyke Ave
Shelby Township, MI 48317-3373

Phone

(586) 323-3620

Fax

(586) 323-3568

NPI assigned

Aug 12, 2008

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

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Clementine Counseling

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Shelby TWP, MI
  • NPI 1265360739
  NPD (past)
• United Psychological Services Inc

  • Clinical Neuropsychologist
  • Shelby TWP, MI
  • NPI 1407947658
  NPD (past)

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

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435708800000",
    "number": "1548416464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47818 VAN DYKE AVENUE",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "48317",
            "telephone_number": "586-323-3620",
            "fax_number": "586-323-3568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47818 VAN DYKE AVE",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483173373",
            "telephone_number": "586-323-3620",
            "fax_number": "586-323-3568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CHRISTINA",
        "middle_name": "LYNNE",
        "credential": "M.A., L.L.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-12",
        "last_updated": "2015-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301013793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM SUBSTANCE ABUSE",
            "identifier": "20576",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1705289",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "028363",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "7509105060",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5266701",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John R Fow III DO PC
• John S LTC Pharmacy Inc (Shelby Family Pharmacy)
• John S LTC Pharmacy Inc. (John S LTC Pharmacy)
• Ida Johns, LLPC
• Arthresa Johnson
• Deborah Marie Johnson, CMT
• Gary Patrick Johnson, DC
• Karl Robert Johnson, D.C.
• Lauren M Johnson
• Nikki Chaza Johnson

• Clinical Psychologist in Shelby Township, MI
• Providers in Shelby Township, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2015; 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.