Provider Demographics
NPI:1457017121
Name:JOHNSON, REBEKAH (LPC, MA)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LPC, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6610 HILLTOP TRL
Mailing Address - Street 2:
Mailing Address - City:SACHSE
Mailing Address - State:TX
Mailing Address - Zip Code:75048-2846
Mailing Address - Country:US
Mailing Address - Phone:214-646-5778
Mailing Address - Fax:
Practice Address - Street 1:6610 HILLTOP TRL
Practice Address - Street 2:
Practice Address - City:SACHSE
Practice Address - State:TX
Practice Address - Zip Code:75048-2846
Practice Address - Country:US
Practice Address - Phone:214-646-5778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-16
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX77262101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional