DR. GLEN LEE JOHNSON (PH.D.) – Clinical Psychologist, NPI 1992758353
Clinical Psychologist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,216 CLINICAL PSYCHOLOGIST in MI
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Provider Addresses for DR. GLEN LEE JOHNSON (PH.D.)
5123, North Royal Drive, Garfield Township, Grand Traverse County, Michigan, 49684, United States
TRAVERSE CITY, MI 496849201
Phone: (231) 929-7358
Fax: (231) 935-0941
Mailing address matches the actual address.
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.
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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: 2019-05-01
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190501000931 | I | Clinical Psychologist | MI | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 96139 | Administration of psychological or neuropsychological test by technician, each additional 30 minutes | 308 | 39 | $0 |
| 96133 | Evaluation of neuropsychological test, each additional hour | 246 | 41 | $0 |
| 96121 | Exam of neurobehavioral status, each additional hour | 78 | 26 | $0 |
| 96132 | Evaluation of neuropsychological test, first hour | 41 | 41 | $0 |
| 96138 | Administration of psychological or neuropsychological test by technician, first 30 minutes | 29 | 29 | $0 |
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