Healthcare Provider Details

I. General information

NPI: 1154233716
Provider Name (Legal Business Name): CATHERINE NICOLE JOHNSON LPC-ASSOCIATE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 E MAIN ST STE 202C
BRENHAM TX
77833-3785
US

IV. Provider business mailing address

11366 GLENFOREST DR
MONTGOMERY TX
77356-5507
US

V. Phone/Fax

Practice location:
  • Phone: 281-636-8662
  • Fax:
Mailing address:
  • Phone: 281-636-8662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number101353
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: