Individual provider Active NPI

Thomas Christopher Johnson, PSY.D.

  • Clinical Psychologist
  • Prosper, TX
National Provider Identifier
1891245254
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
36671 Issued in TX
Practice address
130 N Preston Rd Ste 107
Prosper, TX 75078-3185
Phone
(972) 275-6880
Fax
(844) 205-9001
NPI assigned
Oct 10, 2016
Last updated
Jan 26, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 36671 TX Primary

Addresses

Primary practice location

130 N Preston Rd Ste 107
Prosper, TX 75078-3185

Mailing address

130 N Preston Rd Ste 107
Prosper, TX 75078-3185
Phone (972) 275-6880

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
36671TXMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ally Psychological Health PLLC CurrentSince Jan 29, 2023 Accepting new patients
Balanced Psychology PLLC CurrentSince Feb 12, 2023 Accepting new patients

Locations

130 N Preston Rd
Ste 107
Prosper, TX 75078
Phone (972) 275-6880

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1476057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1891245254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 N PRESTON RD STE 107",
            "city": "PROSPER",
            "state": "TX",
            "postal_code": "750783185",
            "telephone_number": "972-275-6880",
            "fax_number": "844-205-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 N PRESTON RD STE 107",
            "city": "PROSPER",
            "state": "TX",
            "postal_code": "750783185",
            "telephone_number": "972-275-6880",
            "fax_number": "844-205-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "THOMAS",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-10",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "36671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prosper, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; 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.