Provider Demographics
NPI:1215791801
Name:JOHNSON, LADONNA JEANNIE (LPC)
Entity type:Individual
Prefix:
First Name:LADONNA
Middle Name:JEANNIE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:JEANNIE
Other - Middle Name:
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:6633 JOHN HICKMAN PKWY
Mailing Address - Street 2:#508
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-9756
Mailing Address - Country:US
Mailing Address - Phone:817-966-6540
Mailing Address - Fax:
Practice Address - Street 1:6633 JOHN HICKMAN PKWY APT 508
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-9756
Practice Address - Country:US
Practice Address - Phone:817-966-6540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX87831101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional