MEDICARE: SANDI DIANE JOHNSON LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	94400	TX

General Provider Information

NPI Number	:	1790543056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDI DIANE JOHNSON LPC

Provider Business Mailing Address
First Line	:	637 SILVERTOP RD
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76002-4533
Country	:	US
Telephone Number	:	817-901-2950
Fax Number	:

Provider Business Practice Location Address
First Line	:	320 E WINTERGREEN RD APT 8B
Second Line	:
City	:	DESOTO
State	:	TX
Zip	:	75115-2454
Country	:	US
Telephone Number	:	817-901-2950
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/11/2024
Last Update Date	:	04/13/2026

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Directions to “ SANDI DIANE JOHNSON LPC” Practice Location

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