Provider Demographics
NPI:1154773919
Name:JOHNSON, VENENZIA LYNN (MSSW, LCSW)
Entity type:Individual
Prefix:MRS
First Name:VENENZIA
Middle Name:LYNN
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MSSW, LCSW
Other - Prefix:MS
Other - First Name:VENENZIA
Other - Middle Name:LYNN
Other - Last Name:GONZALEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11733 TIMBER HEIGHTS DR.
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78754-5932
Mailing Address - Country:US
Mailing Address - Phone:512-546-3342
Mailing Address - Fax:
Practice Address - Street 1:11733 TIMBER HEIGHTS DR.
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78754-5932
Practice Address - Country:US
Practice Address - Phone:512-546-3342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-05
Last Update Date:2024-08-04
Deactivation Date:2018-02-27
Deactivation Code:
Reactivation Date:2024-08-01
Provider Licenses
StateLicense IDTaxonomies
TX1038271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical