Provider Demographics
NPI:1497332860
Name:JOHNSON, RENEE (LPC)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:
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 1:20922 HEATHER GROVE CT
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77346-1279
Mailing Address - Country:US
Mailing Address - Phone:281-798-0294
Mailing Address - Fax:
Practice Address - Street 1:20922 HEATHER GROVE CT
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77346-1279
Practice Address - Country:US
Practice Address - Phone:281-798-0294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-24
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81724101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional