Active NPI
Lauren B Johnson, PHD
- Clinical Psychologist
- MC Lean, VA
National Provider Identifier
1669130282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY004863
- Practice address
- 1390 Chain Bridge Rd # 50032
MC Lean, VA 22101-3904 - Phone
- (678) 266-7398
- NPI assigned
- Dec 1, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 0810007670 | VA | |
| Clinical Psychologist | 103TC0700X | PSY004863 | GA | Primary |
Addresses
Primary practice location
1390 Chain Bridge Rd # 50032
MC Lean, VA 22101-3904
Mailing address
1390 Chain Bridge Rd # 50032
MC Lean, VA 22101-3904
Phone (678) 266-7398
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 3, 2025 through Apr 3, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY004863 | GA | MD | Clinical Psychologist |
| 0810007670 | VA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1638316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754870400000",
"number": "1669130282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1390 CHAIN BRIDGE RD # 50032",
"city": "MC LEAN",
"state": "VA",
"postal_code": "221013904",
"telephone_number": "678-266-7398"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1390 CHAIN BRIDGE RD # 50032",
"city": "MC LEAN",
"state": "VA",
"postal_code": "221013904",
"telephone_number": "678-266-7398"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "LAUREN",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-12-01",
"last_updated": "2025-08-11",
"certification_date": "2025-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VA",
"license": "0810007670",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "GA",
"license": "PSY004863",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in MC Lean, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.