| Kristine Mciver Johnson Phd Llc | |
|
1201 Wakarusa Dr Bldg E Lawrence KS 66049 | |
| (785) 218-4426 | |
| Not Available |
| Full Name | Kristine Mciver Johnson Phd Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1201 Wakarusa Dr Bldg E, Lawrence, Kansas |
| Authorized Official Name and Position | Kristine Mciver Johnson (OWNER) |
| Authorized Official Contact | 7852184426 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kristine Mciver Johnson Phd Llc 1105 Jana Ct Lawrence KS 66049-4417 Ph: () - | Kristine Mciver Johnson Phd Llc 1201 Wakarusa Dr Bldg E Lawrence KS 66049 Ph: (785) 218-4426 |
| NPI Number | 1548759277 |
|---|---|
| Provider Enumeration Date | 05/08/2018 |
| Last Update Date | 01/03/2019 |
| Medicare PECOS PAC ID | 1456606680 |
|---|---|
| Medicare Enrollment ID | O20180612001751 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548759277 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | LP1118 (Kansas) | Primary |
| Provider Name | Kristine L Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700826195 PECOS PAC ID: 5294929295 Enrollment ID: I20101103001278 |
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