MEDICARE: DR. ERIKA JOHNSON PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	NLC.0013739	CO
2	103T00000X	Psychologist	PSY.0004996	CO

General Provider Information

NPI Number	:	1255884110
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIKA JOHNSON PSYD

Provider Business Mailing Address
First Line	:	6445 CASUAL DRIVE
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80923
Country	:	US
Telephone Number	:	720-402-6648
Fax Number	:

Provider Business Practice Location Address
First Line	:	1935 DOMINION WAY STE 101
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-1464
Country	:	US
Telephone Number	:	719-423-7428
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2016
Last Update Date	:	01/24/2021

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