Provider Demographics
NPI:1578896056
Name:JOHNSON, VALERIE MEGHAN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:MEGHAN
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:MEGHAN
Other - Last Name:MONTEMAYOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 65851
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79464-5801
Mailing Address - Country:US
Mailing Address - Phone:806-332-4565
Mailing Address - Fax:
Practice Address - Street 1:3506 21ST ST STE 400
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1200
Practice Address - Country:US
Practice Address - Phone:805-725-4115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-15
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSYCHOLOGIST#2012535103TC0700X
TX38191103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical