Provider Demographics
NPI:1508365602
Name:JOHNSON, TENISHA LAVON (LPC)
Entity Type:Individual
Prefix:MISS
First Name:TENISHA
Middle Name:LAVON
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 1:20211 WEEPING PINE WAY
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-2033
Mailing Address - Country:US
Mailing Address - Phone:903-714-3009
Mailing Address - Fax:713-970-7246
Practice Address - Street 1:3737 DACOMA ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-8905
Practice Address - Country:US
Practice Address - Phone:713-970-7000
Practice Address - Fax:713-970-7246
Is Sole Proprietor?:No
Enumeration Date:2018-02-05
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75073101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional