Provider Demographics
NPI:1346058872
Name:JOHNSON, DENISE YVETTE (LPC)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:YVETTE
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 1:6518 RUNAWAY ROW
Mailing Address - Street 2:
Mailing Address - City:CONVERSE
Mailing Address - State:TX
Mailing Address - Zip Code:78109-3884
Mailing Address - Country:US
Mailing Address - Phone:210-316-3799
Mailing Address - Fax:
Practice Address - Street 1:17300 HENDERSON PASS STE 260
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-1568
Practice Address - Country:US
Practice Address - Phone:210-908-7573
Practice Address - Fax:210-807-8789
Is Sole Proprietor?:No
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX77317101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health