AMANDA JOHNSON (PHD) – Mental Health Counselor, NPI 1831409770

AMANDA JOHNSON (PHD) is a healthcare provider. based in Grinnell, Iowa. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PHD. They hold a License No. 001202 (IA). The NPI Number for AMANDA JOHNSON (PHD) is 1831409770

Main info

Female
16 Years Of Experience
Accepts Medicare Assignment
Name
AMANDA JOHNSON (PHD)
NPI
1831409770
Phone
(641) 236-6137
Address
200 4TH AVE W
Enumeration Date
13 October 2010
Last Update Date
4 January 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6415286065
Graduation Year
2010 (16 years ago)
PAC ID
6800065608
Group Practice PAC ID
0648169573
Professional Enrollment ID
I20110812000171
Address ID
IA501121833GR200XXWXXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness75
Years active:15State licenses:1Digital endpointsOther names

192 CLINICAL PSYCHOLOGIST in IA

Provider Addresses for AMANDA JOHNSON (PHD)

  • 200 4TH AVE W

    GRINNELL, IA 50112

    Phone: (641) 236-6137

    Fax: (641) 236-0206

    Type: Mailing

  • 1123 1ST AVE E STE 200

    NEWTON, IA 502083981

    Phone: (641) 792-4012

    Fax: (641) 791-0697

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-08-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110812000171IClinical PsychologistIATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 50112)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0648169573View full group profile
NameSpecialtyState
Mental Health CounselorIA
-IA
Physician AssistantIA
-IA
Nurse PractitionerIA
Physician AssistantIA
Physician AssistantIA
P S Y C H I A T R YIA
Clinical Social WorkerIA
-IA

Reviews

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Frequently asked questions

Is there an official ID for AMANDA JOHNSON (PHD) in U.S. healthcare records?
The official identifier for AMANDA JOHNSON (PHD) is NPI 1831409770.
Is AMANDA JOHNSON (PHD) shown as active in public data?
Registry records indicate AMANDA JOHNSON (PHD) maintains an active NPI.
What area of care is associated with AMANDA JOHNSON (PHD)?
AMANDA JOHNSON (PHD)'s record emphasizes Mental Health Counselor. Clinical services aligned with this taxonomy classification.
What practice footprint exists for AMANDA JOHNSON (PHD)?
Travel planning: use Grinnell, Iowa as the reference point for AMANDA JOHNSON (PHD), then confirm.
When was this NPI issued?
Enumeration for AMANDA JOHNSON (PHD) is noted as October 13, 2010 where the registry provides it.

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