Tisha M Johnson, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY003640 Issued in GA

Practice address

2255 Cumberland Pkwy SE
Building 600, Suite 150
Atlanta, GA 30339-4515

Phone

(404) 419-7895

Fax

(404) 419-7891

NPI assigned

Jun 22, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: tisha.johnson.1@27693.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.

• Counseling and Psychological Services - Charlotte

  • Psychologist
  • Charlotte, NC
  • NPI 1619689353
  NPD Authorized official
• Counseling and Psychological Services - Atlanta

  • Psychologist
  • Atlanta, GA
  • NPI 1730557919
  NPD (past) Authorized official

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

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471564800000",
    "number": "1629274089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 950032",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303772032",
            "telephone_number": "404-419-7895",
            "fax_number": "404-419-7891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 CUMBERLAND PKWY SE",
            "address_2": "BUILDING 600, SUITE 150",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303394515",
            "telephone_number": "404-419-7895",
            "fax_number": "404-419-7891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TISHA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-22",
        "last_updated": "2016-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY003640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003135556B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Theodore Michael Johnson II, M.D.
• Thomas William Johnson, D.C.
• Tianna E. Johnson, D.O.
• Tierney Johnson
• Tiffany Renee Johnson, APRN
• Tonja T Johnson, M.D.
• Traci Burkett Johnson, SLP
• Travis David Johnson, AA
• Treecie Lee Johnson, NP
• Valerie L Johnson, M.D.

• Psychologist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2016; 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.