Healthcare Provider Details

I. General information

NPI: 1487164554
Provider Name (Legal Business Name): MICHELLE JOHNSON LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2017
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 BIRCH ALY STE 240
DAYTON OH
45440-1477
US

IV. Provider business mailing address

10777 WESTHEIMER RD STE 1100
HOUSTON TX
77042-3462
US

V. Phone/Fax

Practice location:
  • Phone: 833-240-5954
  • Fax: 833-240-5956
Mailing address:
  • Phone: 833-240-5954
  • Fax: 833-240-5956

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number74137
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number74137
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: