Healthcare Provider Details

I. General information

NPI: 1992620686
Provider Name (Legal Business Name): CARLOS MARTIN JOHNSON LPC-A
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4304 SW GREEN OAKS BLVD STE 100
ARLINGTON TX
76017-2367
US

IV. Provider business mailing address

4304 SW GREEN OAKS BLVD STE 100
ARLINGTON TX
76017-2367
US

V. Phone/Fax

Practice location:
  • Phone: 214-444-8204
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number101045
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: