Provider Demographics
NPI:1497068993
Name:JOHNSON, ROLANDA ROSHELLE (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:ROLANDA
Middle Name:ROSHELLE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4145 OSBY DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-4637
Mailing Address - Country:US
Mailing Address - Phone:832-618-2468
Mailing Address - Fax:
Practice Address - Street 1:2626 S LOOP W
Practice Address - Street 2:SUITE 650-X
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2654
Practice Address - Country:US
Practice Address - Phone:832-618-2468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-26
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19853101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional