Provider Demographics
NPI:1235416033
Name:JOHNSON, JAMES G (JAMES JOHNSON)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:G
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:JAMES JOHNSON
Other - Prefix:
Other - First Name:BO
Other - Middle Name:
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:4422 87TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-4232
Mailing Address - Country:US
Mailing Address - Phone:512-944-7876
Mailing Address - Fax:
Practice Address - Street 1:1311 CHISHOLM TRL STE 301
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-2969
Practice Address - Country:US
Practice Address - Phone:512-944-7876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-08
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
TX64947101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional