| Courtney E. Johnson, Ph.d. L.l.c. | |
|
8100 E 22nd St N Bldg 1, Suite 2 Wichita KS 67226-2388 | |
| (316) 337-5432 | |
| (316) 337-5481 |
| Full Name | Courtney E. Johnson, Ph.d. L.l.c. |
|---|---|
| Speciality | Psychologist |
| Location | 8100 E 22nd St N, Wichita, Kansas |
| Authorized Official Name and Position | Courtney E Johnson (PSYCHOLOGIST) |
| Authorized Official Contact | 3163375432 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Courtney E. Johnson, Ph.d. L.l.c. 8100 E 22nd St N Bldg 1, Suite 2 Wichita KS 67226-2388 Ph: (316) 337-5432 | Courtney E. Johnson, Ph.d. L.l.c. 8100 E 22nd St N Bldg 1, Suite 2 Wichita KS 67226-2388 Ph: (316) 337-5432 |
| NPI Number | 1013288596 |
|---|---|
| Provider Enumeration Date | 01/16/2012 |
| Last Update Date | 01/16/2012 |
| Medicare PECOS PAC ID | 8426219825 |
|---|---|
| Medicare Enrollment ID | O20120411000711 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013288596 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | LP1011 (Kansas) | Primary |
| Provider Name | Courtney E Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881764355 PECOS PAC ID: 1850291568 Enrollment ID: I20040109000854 |
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