Healthcare Provider Details

I. General information

NPI: 1518504356
Provider Name (Legal Business Name): LEXUS JADE JOHNSON BCBA, LBA, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2019
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

914 CHAPEL HILL RD STE A
BURLINGTON NC
27215-6715
US

IV. Provider business mailing address

102 SHORE LAKE DR APT H
GREENSBORO NC
27455-1474
US

V. Phone/Fax

Practice location:
  • Phone: 855-767-3527
  • Fax:
Mailing address:
  • Phone: 763-381-1676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number13735245-2506
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: