JACQUELINE JOHNSON (NPI# 1811160740) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811160740 |
| Entity Type | Individual |
| Full Name | JACQUELINE JOHNSON |
| Practice Address |
2107 Gardenwood Ct Atlanta GA 30349 |
| Mailing Address |
2107 Gardenwood Ct Atlanta GA 30349-3206 |
| Practice Telephone | 4048578639 |
| Mailing Telephone | 4048578639 |
| Mailing Fax Number | 4048631541 |
| Enumeration Date | 2008-04-11 |
| Last Update Date | 2019-08-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TH0100X |
Psychologist Specialization: Health Service |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 372320984B | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679114508 | Jacqueline Johnson | Peer Specialist | 773 Gilbert St, Columbus, OH 43206-1516 | 2019-10-02 |
| 1609433804 | Jacqueline Collette Johnson | Massage Therapist | 612 Madeira Dr Se, Albuquerque, NM 87108-3614 | 2019-05-22 |
| 1174189559 | Jacqueline Johnson | Counselor | 1550 Latimer St, Philadelphia, PA 19102-4417 | 2019-05-11 |
| 1942771738 | Jacqueline M Johnson | Counselor | 1304 E Cardeza St, Phila, PA 19119-1545 | 2018-12-06 |
| 1619497468 | Jacqueline Johnson | Specialist/Technologist | 2812 Mulberry St, Saint Joseph, MO 64501-2649 | 2017-06-22 |
| 1063957009 | Jacqueline Johnson | Nurse Practitioner | 420 S. Glendora Ave, West Covina, CA 91790 | 2016-12-29 |
| 1003359951 | Jacqueline Johnson | Registered Nurse | 822 Red Tip Dr, Allen, TX 75002-5023 | 2016-11-27 |
| 1760840896 | Jacqueline Johnson | Massage Therapist | 485 Alexander Loop Ste 110, Eugene, OR 97401-6753 | 2016-02-03 |
| 1437550571 | Jacqueline Johnson | Psychologist | 2592 Western Ave Ste 200, Altamont, NY 12009-9401 | 2014-09-09 |
| 1568719771 | Jacqueline Marjorie Johnson | Psychologist | 170 Forestview Dr, Williamsville, NY 14221-1416 | 2012-08-07 |
| Street Address |
2107 GARDENWOOD CT |
| City | ATLANTA |
| State | GA |
| Zip Code | 30349 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376185686 | Kmb Diagnostics | Durable Medical Equipment & Medical Supplies | 941 Flat Shoals Rd, Atlanta, GA 30349 | 2019-10-09 |
| 1114575859 | Justin Vassell | Registered Nurse | 1903 Phoenix Boulevard, Suite 200, College Park, GA 30349 | 2019-08-27 |
| 1841856663 | Kennyetta Danielle Watkins | Counselor | 1431 Riverwalk Ln, Apt. F, College Park, GA 30349 | 2019-05-16 |
| 1275002636 | Patriot Healthcare of Georgia, LLC | Family Medicine | 1587 Phoenix Boulevard, Suite 6, College Park, GA 30349 | 2018-11-15 |
| 1669971875 | Ee Consulting Solution | Case Management | 6320 Topaz Tral, Arlanta, GA 30349 | 2018-02-03 |
| 1629595640 | Shayla Bouie | Contractor | 5420 Riverdale Rd Apt D17, Atlanta, GA 30349 | 2017-08-30 |
| 1114475563 | Jasmine V Mccully | Social Worker | 5864 Summergien Lane, College Park, GA 30349 | 2016-09-14 |
| 1639537681 | Shelia Thornton | Counselor | 5856 Seabright Lane, Atlanta, GA 30349 | 2016-02-05 |
| 1346610177 | Joanne Resilard | Nurse Practitioner | 2931 Herron Ln Sw, Atlanta, GA 30349 | 2015-10-06 |
| 1063805091 | Southwest Atlanta Medical & Rehabilitation Clinic LLC | Family Medicine | 495 85 Circle, Suite 100, Atlanta, GA 30349 | 2015-03-16 |
| Find all providers in zip 30349 | ||||
| Taxonomy Code | 103TH0100X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Health Service |
| A psychologist, certified/licensed at the independent practice level in his/her state, who is duly trained and experienced in the delivery of direct, preventative, assessment, and therapeutic intervention services to individuals whose growth, adjustment, or functioning is actually impaired or is demonstrably at high risk of impairment (1974). |
| Notes: Source: National Register of Health Service Providers in Psychology website http://www.nationalregister.org/about_NR.html [7/1/2006: modified title, added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629692595 | Karol Short | Psychologist | 101 Sable Chase Blvd, Mcdonough, GA 30253-3456 | 2020-06-05 |
| 1740834092 | Shenitta Guyton | Psychologist | 619 Grecken Grn, Peachtree City, GA 30269 | 2019-07-25 |
| 1265092654 | Calvary Healthcare, Inc | Psychologist | 256 Van Dell Dr, Rock Spring, GA 30739-2640 | 2019-06-18 |
| 1215597182 | Mind Family & Social Services, Inc | Psychologist | 153 Lee Byrd Rd # 3, Loganville, GA 30052-2310 | 2019-06-13 |
| 1790206555 | Lauren Elizabeth Bigham | Psychologist | 997 Saint Sebastian Way # Eg202110, Augusta, GA 30912-2613 | 2017-07-03 |
| 1154729333 | Katie C Daniels | Psychologist | 1119 Old River Rd, Darien, GA 31305 | 2014-12-19 |
| 1093070773 | Family First Medical Center LLC | Psychologist | 1203 Cleveland Ave Ste 1, East Point, GA 30344-3417 | 2012-07-09 |
| 1841310497 | Walter Gregory Cox | Psychologist | 2923 Player St, Brunswick, GA 31520-4950 | 2007-03-29 |
| 1699882068 | Thomas H. White | Psychologist | 451 Ee Butler Pkwy, Gainesville, GA 30501-4524 | 2006-08-23 |
| 1124353339 | Pro- Holism Professional Corporation | Psychologist | 2480 Windy Hill Rd Se, Suite 206, Marietta, GA 30067-8644 | 2009-10-06 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.