DR. CLIFFORD ALAN JOHANNSEN (NPI# 1962627901) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962627901 |
| Entity Type | Individual |
| Full Name | DR. CLIFFORD ALAN JOHANNSEN |
| Credential | PH.D. |
| Practice Address |
635 Church St Ne Salem OR 97301-2402 |
| Mailing Address |
Po Box 2004 Lake Oswego OR 97035-0626 |
| Practice Telephone | 5033999691 |
| Practice Fax Number | 5033999401 |
| Mailing Telephone | 5032465986 |
| Mailing Fax Number | 5032468050 |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 103T00000X | Psychologist | 0935 | OR | Behavioral Health & Social Service Providers |
| X | 103TA0400X |
Psychologist Specialization: Addiction (Substance Use Disorder) |
0935 | OR | Behavioral Health & Social Service Providers |
| X | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
0935 | OR | Behavioral Health & Social Service Providers |
| X | 103TC0700X |
Psychologist Specialization: Clinical |
0935 | OR | Behavioral Health & Social Service Providers |
| X | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
0935 | OR | Behavioral Health & Social Service Providers |
| X | 103TF0200X |
Psychologist Specialization: Forensic |
0935 | OR | Behavioral Health & Social Service Providers |
| X | 103TP2701X |
Psychologist Specialization: Group Psychotherapy |
0935 | OR | Behavioral Health & Social Service Providers |
| X | 106H00000X | Marriage & Family Therapist | 0935 | OR | Behavioral Health & Social Service Providers |
| Street Address |
635 CHURCH ST NE |
| City | SALEM |
| State | OR |
| Zip Code | 97301-2402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477582906 | David Neale Sweet | Psychologist | 635 Church St Ne, Salem, OR 97301-2402 | 2006-06-30 |
| 1760514483 | Ada Molinoff | Psychologist | 635 Church St Ne, Salem, OR 97301-2402 | 2007-03-09 |
| 1427103886 | Jerome S Gordon | Psychologist | 635 Church St Ne, Salem, OR 97301-2402 | 2007-01-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205450970 | Jehan Seals | Behavior Technician | 3400 State St Set G750, Salem, OR 97301 | 2020-05-29 |
| 1093335929 | Sterling Recovery, LLC | Dietitian, Registered | 3758 Amber St Ne #105, Salem, OR 97301 | 2020-04-21 |
| 1760018360 | Riverfront Mental Health LLC | Counselor | 338 State St, Suite 985, Salem, OR 97301 | 2020-03-16 |
| 1871126888 | Amity Beth Haddon Maxwell | Social Worker | Oregon State Hospital, 2600 Center St Ne, Salem, OR 97301 | 2020-02-18 |
| 1861042632 | Brenda Grizelda Vargas | Behavioral Analyst | 3400 State Ste Ste G750, Salem, OR 97301 | 2019-09-13 |
| 1588213177 | Natalie Stone | Registered Nurse | 2045 Siverton Rd Ne, Salem, OR 97301 | 2019-09-06 |
| 1588228720 | Jeramy Disenso | Counselor | 270 Cottage St Ne, Salem, OR 97301 | 2019-04-23 |
| 1801353297 | Gwendolyn Kersey | Registered Nurse | 2600 Center St Ne Oregon State Hospital, Salem, OR 97301 | 2019-02-21 |
| 1841769114 | Spine Clinic PC | Massage Therapist | 1281 Lancaster Drive Ne, Salem, OR 97301 | 2018-11-16 |
| 1013482132 | Kellie Linn Hansen | Physical Therapist | 4049 Market St Se, Salem, OR 97301 | 2018-10-04 |
| Find all providers in zip 97301 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619583408 | Kyleemillerphd | Psychologist | 586 Welcome Way Se, Salem, OR 97302-3932 | 2020-09-17 |
| 1275196016 | Brittany Evelyn St. Jean | Psychologist | 27 Meisner Rd, Salem, NH 03079-2707 | 2019-04-17 |
| 1689162323 | Joyce Ann Perrotta | Psychologist | 57 Federal St, Salem, MA 01970-3436 | 2018-04-27 |
| 1851888119 | Muriel Portugal Rivera | Psychologist | 7 Lyme St, Salem, MA 01970-4817 | 2018-04-21 |
| 1568839298 | Katherine Russell | Psychologist | 10 Federal Street, Suite 307, Salem, MA 01970-5402 | 2015-08-28 |
| 1962888388 | Carilyn Claire Ellis | Psychologist | 3857 Wolverine St Ne Ste 6, Salem, OR 97305-4274 | 2015-08-07 |
| 1528300399 | Cassandra Sieg | Psychologist | 454 17th St Ne, Salem, OR 97301-4223 | 2013-03-20 |
| 1821335613 | Key Rehabilitation,inc. | Psychologist | 35625 Highway 72, Salem, MO 65560-7217 | 2013-01-14 |
| 1700170818 | David Cory Brillhart | Psychologist | 189 Liberty St., Ne, Suite 210a, The Reed Opera House, Salem, OR 97301 | 2011-06-06 |
| 1659517431 | Gerald Mark Farber | Psychologist | 50 Freedom Holw Unit 218, Salem, MA 01970-6626 | 2008-12-26 |
| Find all providers in SALEM | ||||
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| 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.