Provider Demographics
NPI:1801554266
Name:JOHNSON, DESIREE CHRISTINA (LPC)
Entity type:Individual
Prefix:
First Name:DESIREE
Middle Name:CHRISTINA
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 1:29011 WALTHAM ST
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-2465
Mailing Address - Country:US
Mailing Address - Phone:318-512-9538
Mailing Address - Fax:
Practice Address - Street 1:29011 WALTHAM ST
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-2465
Practice Address - Country:US
Practice Address - Phone:318-512-9538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-02
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX82976101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional