Provider Demographics
NPI:1639439771
Name:JOHNSON, ANGELA FAYE (LPC)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:FAYE
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 1:2450 LOUISIANA ST
Mailing Address - Street 2:STE. 400 #122
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-2380
Mailing Address - Country:US
Mailing Address - Phone:713-446-9706
Mailing Address - Fax:
Practice Address - Street 1:2450 LOUISIANA ST
Practice Address - Street 2:STE. 400 #122
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-2380
Practice Address - Country:US
Practice Address - Phone:713-446-9706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-23
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66803101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health