Beth A Johnson, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2297-057 Issued in WI

Practice address

161 W Wisconsin Ave
Pewaukee, WI 53072-3467

Phone

(262) 695-8857

Fax

(262) 695-8879

NPI assigned

Jun 29, 2006

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)

Enrolled

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.

• Behavioral Solutions, Inc.

  • Nurse Practitioner
  • Milwaukee, WI
  • NPI 1174633119
  NPD (past)

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811925613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N75W23310 N RIDGEVIEW CIR",
            "city": "SUSSEX",
            "state": "WI",
            "postal_code": "530892063",
            "telephone_number": "262-820-1628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 W WISCONSIN AVE",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530723467",
            "telephone_number": "262-695-8857",
            "fax_number": "262-695-8879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BETH",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "2297-057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39790300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Janzer, PA-C
• Luis Fernando Jasso Chavez
• JNMJ LLC
• Sean A. Jochims, M.D.
• Adam Joerres
• Grant Logan Johnson, DC
• Paul Ronald Johnson, M.D.
• Joints in Motion Medical, LLC
• Rod Joseph
• Theresa Gloria Kaczmarek, RN

• Clinical Psychologist in Pewaukee, WI
• Providers in Pewaukee, WI by specialty
• Clinical Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.