Provider Demographics
NPI:1629163258
Name:JOHNSON, JENNIFER PAPPE (LPC LMFT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:PAPPE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LPC LMFT
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:CHRISTINE
Other - Last Name:PAPPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC LMFT
Mailing Address - Street 1:1616 PARK PLACE AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76110-1377
Mailing Address - Country:US
Mailing Address - Phone:817-921-2401
Mailing Address - Fax:817-921-2405
Practice Address - Street 1:1616 PARK PLACE AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76110-1377
Practice Address - Country:US
Practice Address - Phone:817-921-2401
Practice Address - Fax:817-921-2405
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17601101YP2500X
TX5013106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist