Individual provider Active NPI

Lawrence Joseph Johnson, PH.D.

  • Psychologist
  • Toledo, OH
National Provider Identifier
1861410367
Registry record updated Jun 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3453 Issued in OH
Practice address
4149 N Holland Sylvania Rd
Suite 6
Toledo, OH 43623-4808
Phone
(419) 535-1901
Fax
(419) 537-1922
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3453 OH Primary

Addresses

Primary practice location

4149 N Holland Sylvania Rd
Suite 6
Toledo, OH 43623-4808

Mailing address

4149 N Holland Sylvania Rd
Suite 6
Toledo, OH 43623-4808
Phone (419) 535-1901

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

LicenseStateTypeSpecialty
3453OHMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403136000000",
    "number": "1861410367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4149 N HOLLAND SYLVANIA RD",
            "address_2": "SUITE 6",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234808",
            "telephone_number": "419-535-1901",
            "fax_number": "419-537-1922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4149 N HOLLAND SYLVANIA RD",
            "address_2": "SUITE 6",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234808",
            "telephone_number": "419-535-1901",
            "fax_number": "419-537-1922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LAWRENCE",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2014-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "3453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2014; 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.