Individual
JACQUELINE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1 WEST AVE STE 230, SARATOGA SPRINGS, NY 12866-6050
(518) 583-5300
Mailing address
1 WEST AVE STE 230, SARATOGA SPRINGS, NY 12866-6050
(518) 583-5300
(518) 370-7401
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
015812-1
NY
103TC0700X
Clinical Psychologist
Primary
015812
NY
103TM1800X
Intellectual & Developmental Disabilities Psychologist
015812
NY
103TS0200X
School Psychologist
015812
NY
Other
Enumeration date
09/09/2014
Last updated
07/16/2025
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