Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Jack Allen Johnson Jr., PHD

Individual provider Psychologist · NPI 1295992030

Dr. Jack Allen Johnson Jr., PHD is a Clinical Psychologist in Baton Rouge, Louisiana. Qualified in 2001, 25 years ago. Practices with Our Lady of the Lake Physician Group LLC, a 635-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Louisiana.

Years since qualifying
25
Licensed in
LA
In the registry since
2008
Specialties on file
4
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

See every abbreviation used in this directory →

Practice location Address checks out

7777 Hennessy Blvd Ste 501B
Baton Rouge, LA 70808-4300
Phone: (225) 765-3456
Fax: (225) 765-5547
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1931 S Burnside Ave, Gonzales, LA 70737-4632 — (225) 743-2346
  • 12469 Timberwood Dr, Walker, LA 70785-5743 — (225) 485-5763

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 990 (LA)
Psychologist Taxonomy 103T00000X · Licence 990 (LA)
Cognitive & Behavioral Psychologist Taxonomy 103TB0200X · Licence 990 (LA)
Intellectual & Developmental Disabilities Psychologist Taxonomy 103TM1800X · Licence 990 (LA)

Record details

NPI number1295992030
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorNo
NPI enumeratedMay 20, 2008
Last updated in NPPESApril 20, 2022
Certification dateApril 20, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2001 (25 years in practice)
Group practice Our Lady Of The Lake Physician Group Llc — 635 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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