Provider Demographics
NPI:1770595779
Name:JOHNS, VICKIE L (LPC)
Entity type:Individual
Prefix:
First Name:VICKIE
Middle Name:L
Last Name:JOHNS
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 1:127 KIMBERLY HL
Mailing Address - Street 2:
Mailing Address - City:PALMER
Mailing Address - State:TX
Mailing Address - Zip Code:75152-9582
Mailing Address - Country:US
Mailing Address - Phone:469-766-7490
Mailing Address - Fax:972-923-9011
Practice Address - Street 1:215 W FRANKLIN ST STE 100
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-3617
Practice Address - Country:US
Practice Address - Phone:469-766-7490
Practice Address - Fax:972-923-9011
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18259T101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional