AMY JOHANSSON (NPI# 1699321851) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699321851 |
| Entity Type | Individual |
| Full Name | AMY JOHANSSON |
| Practice Address |
4350 S National Ave Ste B116 Springfield MO 65810-2658 |
| Practice Telephone | 4178811810 |
| Enumeration Date | 2019-08-14 |
| Last Update Date | 2019-10-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
2019028939 | MO | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 490073828 | 05 | |
| CAQH | 14337212 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1300 E Bradford Pkwy, Springfield, MO 658044264 | 4177615000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215298575 | Amy Kathleen Johansson | Developmental Therapist | 321 Fortune Blvd, Milford, MA 01757-1750 | 2012-06-04 |
| Street Address |
4350 S NATIONAL AVE STE B116 |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65810-2658 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780776807 | Neuropsychological Associates of Southwest Missouri, P.C. | Counselor | 4350 S National Ave Ste B116, Springfield, MO 65810-2658 | 2006-09-28 |
| 1780833046 | Danielle R Day | Counselor | 4350 S National Ave Ste B116, Springfield, MO 65810 | 2008-09-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508373838 | Sunterra Springfield Oc, LLC | Skilled Nursing Facility | 4935 S National Ave, Springfield, MO 65810 | 2018-01-09 |
| 1982119392 | Boyoung Park | Specialist/Technologist | 4355 S National Ave Apt 905, Springfield, MO 65810 | 2017-12-07 |
| 1578086310 | Missouri Telerad LLC | Radiology | 5117 South Neffleton Avenue, Springfiled, MO 65810 | 2017-07-24 |
| 1245597285 | Intrepid of Missouri, Inc. | Hospice Care, Community Based | 4305 S. National Ave., Springfield, MO 65810 | 2012-04-16 |
| 1700199668 | Telerad of Mo Account Management, LLC | Radiology | 5117 S. Neffleton Ave, Springfield, MO 65810 | 2010-07-21 |
| 1427286251 | Sam's Club Optical | Eyewear Supplier (Equipment, not the service) | 745 W El Camino Alto Drive, Springfield (s), MO 65810 | 2009-07-01 |
| 1033344304 | Teresa Mary Kaelin | Occupational Therapist | 3291 W. Ridge Run, Springfield, MO 65810 | 2009-05-15 |
| 1538366448 | Rani K Nair | Internal Medicine | 3231 S National Mercy Endocrineology, Ste 440, Springfield, MO 65810 | 2007-07-03 |
| 1467672519 | Missouri Dental Professionals, Richard Straus, Dmd, PC | Dentist | 4955 S. National Ave., Unit A, Springfield, MO 65810 | 2007-04-30 |
| 1336161983 | Leo Allan Tokarczyk | Dentist | 4777 S National Ave, Springfield, MO 65810 | 2006-07-24 |
| Find all providers in zip 65810 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710509187 | Laura M Maggio | Psychologist | 11 Stephanie Cir, Springfield, MA 01129-1961 | 2020-05-08 |
| 1215556386 | Lotus Healing Center LLC | Psychologist | 28 Millburn Ave Ste 6, Springfield, NJ 07081-1023 | 2020-04-09 |
| 1194359216 | Kathrin A Koehler | Psychologist | 4674 Hominy Ridge Rd, Springfield, OH 45502-8031 | 2020-02-27 |
| 1689126120 | Assessment Consultants, LLC | Psychologist | 2146 W Chesterfield Blvd Ste E202, Springfield, MO 65807-8650 | 2016-11-01 |
| 1003366436 | Caitriona Hayes | Psychologist | 8134 Old Keene Mill Road, Suite 101, Springfield, VA 22152 | 2016-10-10 |
| 1669929907 | Richart Lipe Demier | Psychologist | 5871 S Northern Ridge Rd, Springfield, MO 65810-1976 | 2016-09-03 |
| 1043660905 | Safe Harbor Christian Counseling of Northern Virginia LLC | Psychologist | 8304 Old Keene Mill Rd, Springfield, VA 22152-1640 | 2016-06-21 |
| 1659786432 | Kimberly Wilkins Psyd LLC | Psychologist | 1344 W Oakville Rd, Springfield, MO 65810-1696 | 2014-06-30 |
| 1548507817 | Bahn and Associates | Psychologist | 3000 Professional Dr Ste D, Bahn Consulting, Inc., Springfield, IL 62703-5931 | 2013-01-07 |
| 1396004990 | Cultivate Psychological Services LLC | Psychologist | 1439 S Rogers Ave, Springfield, MO 65804-1129 | 2012-05-16 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65810 |
Please comment or provide details below to improve the information on AMY JOHANSSON.
| 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.