Courtney E Johnson, PH.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

61442566 Issued in WA

Practice address

5137 Blacktail CT NE
Olympia, WA 98516-2136

Phone

(316) 337-5432

Fax

(316) 337-5481

NPI assigned

Nov 9, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in KS, WA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Psychologist

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Courtney E. Johnson, PH.D. L.L.C.

  • Clinical Psychologist
  • Wichita, KS
  • NPI 1013288596

  Clinical, KS, WA

  Medicare reassignment NPD Authorized official
• Behavioral Medicine Specialists, PA

  • Clinical Social Worker
  • Wichita, KS
  • NPI 1881706398

  Psychologist

  NPD (past)

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705708800000",
    "number": "1881764355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 MARVIN RD NE STE C313",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985163878",
            "telephone_number": "316-337-5432",
            "fax_number": "316-337-5481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5137 BLACKTAIL CT NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985162136",
            "telephone_number": "316-337-5432",
            "fax_number": "316-337-5481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "COURTNEY",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2024-01-20",
        "certification_date": "2024-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KS",
            "license": "LP1011",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "61442566",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KS",
            "license": "LP1011",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "61442566",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela E Johnson
• Brenda Johnson
• Cassidy Hope Johnson
• Chloe Johnson
• Christopher S Johnson, P.A.
• Dawn Johnson, LMP
• Debra A Johnson, MD
• Elysia Orion Johnson
• Erik Johnson, LMP
• Eryn Johnson

• All providers in Olympia, WA
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.