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DR. KELLY SUZANNE JOHNSON PSY.D.
NPI 1033254164
Clinical Neuropsychologist in Warrenville, IL

Active since February 20, 2007Opted out of Medicare · through Jan 23, 2028
28379 DAVIS PKWY, SUITE 801 CANTERA LAKES OFFICES-CLARUS CENTER, WARRENVILLE, IL 60555(630) 355-3321(630) 393-0499 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Kelly Suzanne Johnson Psy.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KELLY SUZANNE JOHNSON PSY.D. (NPI 1033254164) is an individual clinical neuropsychologist in Warrenville, Illinois, licensed in Illinois (071-005691) and active in the NPI registry since February 2007. She has opted out of Medicare through January 23, 2028.

NPPES Registry Identity

NPI1033254164
Entity TypeIndividualFemale
Primary Taxonomy103G00000X
Provider Legal NameDR. KELLY SUZANNE JOHNSONCredential: PSY.D.
Location Address28379 DAVIS PKWY, SUITE 801 CANTERA LAKES OFFICES-CLARUS CENTERWarrenville, IL 60555-3032
Mailing Address28379 Davis Pkwy, Suite 801 Cantera Lakes Offices-clarus CenterWarrenville, IL 60555-3032 · (630) 355-3321 · Fax (630) 393-0499
Phone(630) 355-3321
Fax(630) 393-0499
Sole ProprietorYes
Enumeration DateFebruary 20, 2007
Last NPPES UpdateSeptember 11, 2025
✔ NPI 1033254164 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers
Taxonomy Code103G00000X
License✔ Licensed in IL · 071-005691
Definition
A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.
Also ListedPsychologistTaxonomy 103T00000X · License 071-005691 (IL)
28379 DAVIS PKWY, Warrenville, IL 60555
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Kelly Suzanne Johnson Psy.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 23, 2020 through January 23, 2028.

Opt-Out Effective DateJanuary 23, 2020
Opt-Out In Effect ThroughJanuary 23, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MARTIN EDWARD LEMON PH.D.
Psychologist (Clinical)
28379 DAVIS PKWY, SUITE 801
WARRENVILLE, IL 60555
Dupage County (630) 393-9800
DR. THOMAS D O'BRYAN D.C., C.C.N.
Nutritionist (Nutrition, Education)
28379 DAVIS PKWY, SUITE 801
WARRENVILLE, IL 60555
Dupage County (630) 393-9800
HEALTH DOCTORS, LTD.
Chiropractor
28379 DAVIS PKWY, SUITE 803
WARRENVILLE, IL 60555
Dupage County (630) 393-2225
DR. ALLISUN MARIE NOE PSY.D.
Psychologist (Clinical)
28379 DAVIS PKWY, SUITE 801
WARRENVILLE, IL 60555
Dupage County (773) 209-3772
SYNERGISTIC HEALING ARTS INC
Chiropractor (Nutrition)
28379 DAVIS PKWY, SUITE 801
WARRENVILLE, IL 60555
Dupage County (630) 393-9800
MARTIN LEMON, PHD, P.C.
Psychologist (Clinical)
28379 DAVIS PKWY, SUITE 801
WARRENVILLE, IL 60555
Dupage County (630) 393-9800
JANET LEVITT LCPC, PC
Counselor (Mental Health)
28379 DAVIS PKWY, SUITE 801
WARRENVILLE, IL 60555
Dupage County (630) 393-9800
DR. JAMES BRIAN CLAUSSEN D.C.
Chiropractor
28379 DAVIS PKWY, SUITE 803
WARRENVILLE, IL 60555
Dupage County (630) 393-2225

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Johnson's NPI number?

The NPI number for Kelly Johnson is 1033254164. It was assigned to this individual provider in the NPPES registry on February 20, 2007.

Where is Kelly Johnson located?

Kelly Johnson practices at 28379 Davis Pkwy Suite 801 Cantera Lakes Offices-Clarus Center, Warrenville, IL 60555. The listed phone number is (630) 355-3321.

What is Kelly Johnson's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

Is Kelly Johnson enrolled in Medicare?

No. Kelly Johnson has opted out of Medicare through January 23, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Kelly Johnson was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.