Kimberly E Johnson, PSYD, HSPP, APIT

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

20042216A Issued in IN

Practice address

10761 Chesapeake Dr N
Indianapolis, IN 46236-8964

Phone

(317) 748-4520

Fax

(317) 293-1241

NPI assigned

Jan 7, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kimberly.johnson.1@9357.direct.athenahealth.com

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.

• Worldview Psychological Services LLC

  • Clinical Psychologist
  • Indianapolis, IN
  • NPI 1285579920
  NPD Authorized official
• Community Health Network, Inc

  dba Community Fairbanks Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Indianapolis, IN
  • NPI 1265477632
  NPD (past)

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

{
    "created_epoch": "1199664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1629253802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10761 CHESAPEAKE DR N",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462368964",
            "telephone_number": "317-260-8928",
            "fax_number": "317-293-1241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10761 CHESAPEAKE DR N",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462368964",
            "telephone_number": "317-748-4520",
            "fax_number": "317-293-1241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KIMBERLY",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "PSYD, HSPP, APIT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-07",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20042216A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth Clark Johnson, P.T.
• Khalilia Johnson
• Kim Johnson, MHR, D.MIN, CSAYC
• Kimberly Johnson, LMHCA
• Kimberly Diana Johnson, N.P.
• Kirby Ann Johnson, RDN
• Lakeisha Juna Johnson, LMSW
• Lakeshia Cassandra Johnson, PMHNP
• Lasandra Johnson
• Latasha Veronica Johnson, TRANSPORTATION

• Clinical Psychologist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Clinical Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; 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.