Provider Demographics
NPI:1275841272
Name:JOHNSON, LAURA ANN (LPC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ANN
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1116 W MARTIN LUTHER KING DR
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-5352
Mailing Address - Country:US
Mailing Address - Phone:512-940-4608
Mailing Address - Fax:
Practice Address - Street 1:1116 W MARTIN LUTHER KING DR
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-5352
Practice Address - Country:US
Practice Address - Phone:512-940-4608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-24
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64375101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional