Glen Lee Johnson (NPI# 1992758353, PAC ID# 3274875869) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PSYCHOLOGIST, CLINICAL.
Nation Provider ID (NPI) | 1992758353 |
PAC ID by PECOS | 3274875869 |
Professional Enrollment ID | I20190501000931 |
Full Name | Glen Lee Johnson |
Organization Legal Name | GRAND TRAVERSE ASSESSMENT AND THERAPY, PLLC |
Address |
5123 N Royal Dr Traverse City MI 49684-9201 |
Phone Number | 2312528009 |
Gender | M |
Graduation Year | 1982 |
Primary Specialty | PSYCHOLOGIST, CLINICAL |
Group Practice PAC ID | 9638411226 |
Number of Group Practice Members | 2 |
Accepts Medicare Assignment | Y |
Address | Phone | Organization |
---|---|---|
5123 N Royal Dr, Traverse City, MI 49684-9201 | 2312528009 | GRAND TRAVERSE ASSESSMENT AND THERAPY, PLLC |
Organization Legal Name | GRAND TRAVERSE ASSESSMENT AND THERAPY, PLLC |
Physicians | 1 |
Street Address |
5123 N ROYAL DR |
City | TRAVERSE CITY |
State | MI |
Zip | 49684-9201 |
Name | Specialty | Organization | Address |
---|---|---|---|
Autumn D Hull | Physical Therapy | Great Lakes Therapy Housecalls PC | 5123 N Royal Dr, Great Lakes Physical Therapy Center, Traverse City, MI 49684-9201 |
Ann M Dembicky | Occupational Therapy | Great Lakes Therapy Housecalls PC | 5123 N Royal Dr, Great Lakes Physical Therapy Center, Traverse City, MI 49684-9201 |
James A Harvey | Physical Therapy | Great Lakes Therapy Housecalls PC | 5123 N Royal Dr, Great Lakes Physical Therapy Center, Traverse City, MI 49684-9201 |
Rachel E Samborn | Speech Language Pathologist | Great Lakes Therapy Housecalls PC | 5123 N Royal Dr, Traverse City, MI 49684-9201 |
Melissa Michael | Speech Language Pathologist | Great Lakes Therapy Housecalls PC | 5123 N Royal Dr, Great Lakes Physical Therapy Center, Traverse City, MI 49684-9201 |
Katherine A Fain | Physical Therapy | Great Lakes Therapy Housecalls PC | 5123 N Royal Dr, Traverse City, MI 49684-9201 |
Name | Specialty | Organization | Address |
---|---|---|---|
John F Ulrich | Psychologist, Clinical | 102 W Front St, Suite 402, Traverse City, MI 49684-1201 | |
Melanie S Villanueva | Clinical Social Worker | 134 W State St, Suite 202, Traverse City, MI 49684-1491 | |
Hillary R Toennies | Qualified Audiologist | Family Hearing LLC | 315 N Division St, Suite 120, Traverse City, MI 49684-2009 |
Paul Andrew Hanrahan | Qualified Audiologist | Family Hearing LLC | 315 N Division St, Suite 120, Traverse City, MI 49684-2009 |
Barbara Jones Smith | Clinical Psychologist | Barbara Jones Smith Phd PC | 821 S Elmwood C, Traverse City, MI 49684-2191 |
Julie Slough Runstrom | Optometry | Nichols Optical Inc | 336 W Front St, Traverse Vision, Traverse City, MI 49684-2204 |
Christopher James Kowalski | Optometry | Nichols Optical Inc | 336 W Front St, Traverse Vision, Traverse City, MI 49684-2204 |
David Cannon | Optometry | Nichols Optical Inc | 336 W Front St, Traverse Vision, Traverse City, MI 49684-2204 |
Karisa Ritter | Optometry | Nichols Optical Inc | 336 W Front St, Traverse Vision, Traverse City, MI 49684-2204 |
Elizabeth J Nichols | Optometry | Nichols Optical Inc | 336 W Front St, Traverse Vision, Traverse City, MI 49684-2204 |
Find all physicians in zip 49684 |
City | TRAVERSE CITY |
Zip Code | 49684 |
Specialty | PSYCHOLOGIST, CLINICAL |
City + Specialty | TRAVERSE CITY + PSYCHOLOGIST, CLINICAL |
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Data Provider | Centers for Medicare & Medicaid Services (CMS) |
Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.