Active NPI
Regena Pfeffer Johnson, PSY.D
- Clinical Psychologist
- Dunkirk, MD
National Provider Identifier
1821110784
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 03875
- Practice address
- 3175 W Ward Rd
Dunkirk, MD 20754-3020 - Phone
- (410) 286-0664
- Fax
- (410) 286-2834
- NPI assigned
- Apr 4, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 03875 | MD | Primary |
Addresses
Primary practice location
3175 W Ward Rd
Dunkirk, MD 20754-3020
Mailing address
3175 W Ward Rd
Dunkirk, MD 20754-3020
Phone (410) 286-0664
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 58956180 | Medicaid | MD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03875 | MD | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1270080000000",
"number": "1821110784",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3175 W WARD RD",
"city": "DUNKIRK",
"state": "MD",
"postal_code": "207543020",
"telephone_number": "410-286-0664",
"fax_number": "410-286-2834"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3175 W WARD RD",
"city": "DUNKIRK",
"state": "MD",
"postal_code": "207543020",
"telephone_number": "410-286-0664",
"fax_number": "410-286-2834"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PFEFFER JOHNSON",
"first_name": "REGENA",
"name_prefix": "Dr.",
"credential": "PSY.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-04",
"last_updated": "2010-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MD",
"license": "03875",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "58956180",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dunkirk, MD
- Penuel Behavioral Health Services LLC.
- Penuel Behavioral Health Services LLC.
- Penuel Behavioral Health Services LLC.
- Penuel Behavioral Health Services LLC.
- Penuel Behavioral Health Services LLC.
- Potomac Oral and Maxillofacial Surgery Dr Wendell Gardner PA
- Potomac Oral and Maxillofacial Surgery; LLC
- Antwan Proctor
- Marissa Pycha, MSW
- Laura Susana Radesca, DDS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.