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Individual

MISS JENNIE RAE JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCDC, LPC

Contact information

Practice address
801 TRAVIS ST, HOUSTON, TX 77002-5719
(361) 648-5404
Mailing address
15803 HEATHERDALE DR, HOUSTON, TX 77059-5918
(361) 648-5404

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
15566
TX
101YM0800X
Mental Health Counselor
Primary
85171
TX

Other

Enumeration date
06/10/2021
Last updated
03/04/2025
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