DR. JACQLYN DAWN JOHNSON PSYD
NPI 1225544224
Psychologist - Clinical in Washington, DC

Q: What is Jacqlyn Johnson's NPI number?

The NPI number for Jacqlyn Johnson is 1225544224. It was assigned to this individual provider in the NPPES registry on December 28, 2017.

Q: What is Jacqlyn Johnson's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: Is Jacqlyn Johnson enrolled in Medicare?

No. Jacqlyn Johnson has opted out of Medicare through January 18, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Jacqlyn Johnson was last updated on December 28, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years 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.

Active since December 28, 2017Opted out of Medicare · through Jan 18, 2027

1350 CONNECTICUT AVE NW STE 612, WASHINGTON, DC 20036(202) 495-1581 Get Directions Write a Review

NPPES record last updated: December 28, 2017. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Dr. Jacqlyn Dawn Johnson Psyd NPPES

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

DR. JACQLYN DAWN JOHNSON PSYD (NPI 1225544224) is an individual clinical provider in Washington, District Of Columbia, licensed in District Of Columbia (PSY1001330) and active in the NPI registry since December 2017. She has opted out of Medicare through January 18, 2027.

NPPES Registry Identity

NPI1225544224

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameDR. JACQLYN DAWN JOHNSONCredential: PSYD

Location Address1350 CONNECTICUT AVE NW STE 612Washington, DC 20036-1735

Mailing Address1629 Francis Hammond PkwyAlexandria, VA 22302-3915 · (202) 495-1581

Phone(202) 495-1581

Sole ProprietorYes

Enumeration DateDecember 28, 2017

✔ NPI 1225544224 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in DC · PSY1001330

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

1350 CONNECTICUT AVE NW STE 612, Washington, DC 20036

Open in Google Maps ↗

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. Jacqlyn Dawn Johnson Psyd 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 18, 2021 through January 18, 2027.

Opt-Out Effective DateJanuary 18, 2021

Opt-Out In Effect ThroughJanuary 18, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 6

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

MEGAN GOLDBERG LICSW

Social Worker (Clinical)