Jacqueline Johnson, PSYD is a medicare enrolled "Psychologist - Intellectual & Developmental Disabilities" provider in Altamont, New York. Her current practice location is
2592 Western Ave Ste 200, Altamont, New York. You can reach out to her office (for appointments etc.) via phone at
(518) 595-3104.
Jacqueline Johnson is licensed to practice in New York (license number 015812) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1437550571.
Healthcare Provider's Profile
| Full Name | Jacqueline Johnson |
|---|
| Gender | Female |
|---|
| Speciality | Psychologist - Intellectual & Developmental Disabilities |
|---|
| Location | 2592 Western Ave Ste 200, Altamont, New York |
|---|
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1437550571
- Provider Enumeration Date: 09/09/2014
- Last Update Date: 01/25/2023
Medicare PECOS Information:
- PECOS PAC ID: 9133539877
- Enrollment ID: I20230303001967
Medical Identifiers
Medical identifiers for Jacqueline Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1437550571 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103T00000X | Psychologist | 015812-1 (New York) | Secondary |
| 103TC0700X | Psychologist - Clinical | 015812 (New York) | Secondary |
| 103TS0200X | Psychologist - School | 015812 (New York) | Secondary |
| 103TM1800X | Psychologist - Intellectual & Developmental Disabilities | 015812 (New York) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jacqueline Johnson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jacqueline Johnson, PSYD
500 Balltown Rd,
Schenectady, NY 12304-2247
Ph: (518) 388-0425 | Jacqueline Johnson, PSYD
2592 Western Ave Ste 200,
Altamont, NY 12009-9401
Ph: (518) 595-3104 |
Reviews and Comments