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DR. GLEN LEE JOHNSON PH.D.
NPI 1992758353
Psychologist - Clinical in Traverse City, MI

Active since May 18, 2006PECOS EnrolledAccepts Medicare Assignment
5123 N ROYAL DR, TRAVERSE CITY, MI 49684(231) 929-7358(231) 935-0941 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Glen Lee Johnson Ph.d. NPPES

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

DR. GLEN LEE JOHNSON PH.D. (NPI 1992758353) is an individual clinical provider in Traverse City, Michigan, licensed in Michigan (6301006001) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1982).

NPPES Registry Identity

NPI1992758353
Entity TypeIndividualMale
Primary Taxonomy103TC0700X
Provider Legal NameDR. GLEN LEE JOHNSONCredential: PH.D.
Location Address5123 N ROYAL DRTraverse City, MI 49684-9201
Mailing Address5123 N Royal DrTraverse City, MI 49684-9201 · (231) 929-7358 · Fax (231) 935-0941
Phone(231) 929-7358
Fax(231) 935-0941
Sole ProprietorYes
Medical School CMSOtherGraduated 1982
Enumeration DateMay 18, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1992758353 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
Licenses✔ Licensed in MI · 6301006001✔ Licensed in FL · PY7155
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.
5123 N ROYAL DR, Traverse City, MI 49684
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Other Identifiers 1

Medicare ID-Type UnspecifiedOM25720MI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Glen Lee Johnson Ph.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3274875869
PECOS Enrollment IDI20190501000931
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of psychological or neuropsychological test by technician, each additional 30 minutes 96139
This service involves a technician administering additional psychological or neuropsychological testing. Each session lasts for an extra 30 minutes. These tests assess cognitive abilities, such as memory, attention, and problem-solving skills, to aid in diagnosing or monitoring mental health conditions.
529 services67 patients
Evaluation of neuropsychological test, each additional hour 96133
This service involves further evaluation of your neuropsychological test results beyond the initial hour. It helps to understand your cognitive functioning better, focusing on areas like memory, attention, and problem-solving skills.
397 services67 patients
Exam of neurobehavioral status, each additional hour 96121
This procedure involves a thorough evaluation of your neurobehavioral status, focusing on brain functions that affect behavior and cognition. It's extended for an additional hour to gather more detailed information about your neurological health.
181 services61 patients
Evaluation of neuropsychological test, first hour 96132
An evaluation of neuropsychological tests is a process to assess your brain's function. It involves tasks designed to measure cognitive abilities such as memory, attention, problem-solving, and language skills. The first hour involves initial testing and observation.
67 services67 patients
Exam of neurobehavioral status, first hour 96116
An exam of neurobehavioral status is a medical procedure that evaluates your brain's functions. This includes assessing your cognitive abilities, emotional responses, and behavioral patterns. The first hour of the exam is typically dedicated to this initial evaluation.
61 services61 patients
Administration of psychological or neuropsychological test by technician, first 30 minutes 96138
This procedure involves a trained technician administering a psychological or neuropsychological test. It's a process that assesses your mental function and behavior. The initial session will last 30 minutes. The aim is to understand your cognitive abilities better.
14 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49684 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$166.68 typical visit price
range $54.34 – $166.68
Typical copayment $41.67 (range $13.58 – $41.67)
Most-billed visit code 99205
Established Patient
$96.44 typical visit price
range $17.09 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

ACTIVE BRACE AND LIMB LLC
Prosthetic/Orthotic Supplier
5123 N ROYAL DR
TRAVERSE CITY, MI 49684
Grand Traverse County (231) 932-8702
MS. BRIDGET MAUREEN CALLAGHAN MSW
Social Worker (Clinical)
5123 N ROYAL DR
TRAVERSE CITY, MI 49684
Grand Traverse County (231) 947-2440
NEW APPROACHES CENTER
Psychologist (Clinical)
5123 N ROYAL DR
TRAVERSE CITY, MI 49684
Grand Traverse County (231) 929-8383
TROY SUTHERLAND ATC
Rehabilitation Practitioner
5123 N ROYAL DR
TRAVERSE CITY, MI 49684
Grand Traverse County (231) 883-5280
KATHRYN MAXIMIUK LPC
Counselor (Professional)
5123 N ROYAL DR
TRAVERSE CITY, MI 49684
Grand Traverse County (231) 929-8383
UNITED SOFT GOOD ASSOCIATES, LLC
Durable Medical Equipment & Medical Supplies
5123 N ROYAL DR
TRAVERSE CITY, MI 49684
Grand Traverse County (231) 932-8702
MICHELE RENNER CCC-SLP
Speech-Language Pathologist
5123 N ROYAL DR
TRAVERSE CITY, MI 49684
Grand Traverse County (231) 929-8383
ANNALISE BENARDO M.S. CCC-SLP
Speech-Language Pathologist
5123 N ROYAL DR
TRAVERSE CITY, MI 49684
Grand Traverse County (231) 929-8383

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 Glen Johnson's NPI number?

The NPI number for Glen Johnson is 1992758353. It was assigned to this individual provider in the NPPES registry on May 18, 2006.

Where is Glen Johnson located?

Glen Johnson practices at 5123 N Royal Dr, Traverse City, MI 49684. The listed phone number is (231) 929-7358.

What is Glen Johnson's specialty?

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

Is Glen Johnson enrolled in Medicare?

Yes. Glen Johnson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Glen Johnson accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 4 other insurers list Glen Johnson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Glen Johnson was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.