Dr. Courtney E Johnson, Ph.D
Psychologist, Clinical in Olympia, WA. Individual provider (NPI-1).
NPI number1881764355
StatusActive
Last updated in NPPESJan 20, 2024
Details
- NPI
- 1881764355
- Entity type
- Individual (NPI-1)
- Name
- Dr. Courtney E Johnson
- Credential
- Ph.D
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 9, 2006
- Certification date
- Jan 20, 2024
- Last updated
- Jan 20, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - CLINICAL PSYCHOLOGIST
- Can order and refer
- Part B Yes · DME Yes · Home health No · Power mobility No · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | 61442566 | WA | Yes |
| 103TC0700X | Psychologist, Clinical | LP1011 | KS | |
| 103T00000X | Psychologist | LP1011 | KS | |
| 103T00000X | Psychologist | 61442566 | WA |
Practice location
5137 Blacktail Ct NeOlympia, WA 98516-2136
Phone 316-337-5432 · Fax 316-337-5481
Mailing address
1420 Marvin Rd Ne Ste C313Lacey, WA 98516-3878
Phone 316-337-5432 · Fax 316-337-5481
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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