Provider Demographics
NPI:1376256230
Name:WOODEN, JOHNEISHA CHERISE (LPC)
Entity Type:Individual
Prefix:
First Name:JOHNEISHA
Middle Name:CHERISE
Last Name:WOODEN
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 1:901 FM 517 RD W APT 1020
Mailing Address - Street 2:
Mailing Address - City:DICKINSON
Mailing Address - State:TX
Mailing Address - Zip Code:77539-4074
Mailing Address - Country:US
Mailing Address - Phone:281-660-9308
Mailing Address - Fax:
Practice Address - Street 1:901 FM 517 RD W APT 1020
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:TX
Practice Address - Zip Code:77539-4074
Practice Address - Country:US
Practice Address - Phone:281-660-9308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-05
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX87804101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional