Kevin Johnson, PSYD
NPI 1255199774ActiveIndividual· Psychologist· Troy, MI
Psychologist (PSYD) with McLaren Port Huron, practicing in Troy, Michigan. Enrolled in Medicare as practitioner - clinical psychologist. Lists McLaren Port Huron as a hospital affiliation.
Overview
| NPI | 1255199774 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PSYD |
| Sole proprietor | Yes |
| NPI issued | Mar 11, 2024 |
| Last updated in NPPES | Mar 11, 2024 |
| Certified by provider | Mar 8, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist Primary | 103T00000X | 6301019443 | MI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Psychologist (MI) |
|---|
Education and affiliations
| Graduation year | 2018 |
|---|---|
| Medicare specialty | Clinical Psychologist |
Medical group
- McLaren Port HuronPort Huron, MI · 52 clinicians
Hospital affiliation
- McLaren Port HuronPort Huron, MI
Other Psychologist providers in Troy
- 1477924611
- 1770596587
- 1699512509
- 1538754437
- 1073158606
- 1326954082
- 1528377264
- 1518774249
- 1134990112
- 1124804497
- 1811801491
- 1013484591