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NPI 1639890064

NPI 1639890064 : JOHANA JIMENEZ LPC : DALLAS, TX

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General NPI Number Information
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    NPI Number           |    1639890064
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    Entity Type          |    Individual 
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    Provider Name        |    JOHANA JIMENEZ LPC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/05/2022
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    Last Update Date     |    07/25/2025
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Provider Practice Location Address
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    Address Line         |    14114 DALLAS PKWY STE 560 
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    City                 |    DALLAS
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    State                |    TX
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    Zip                  |    75254-1343
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    Country              |    US
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    Telephone            |    940-600-1139
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    14114 DALLAS PKWY STE 560325 
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    City                 |    DALLAS
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    State                |    TX
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    Zip                  |    75254-4325
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    Country              |    US
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    Telephone            |    940-600-1139
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YP2500X
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    Taxonomy Name        |    Professional Counselor
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    License Number       |    83218
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    License Number State |    TX
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Taxonomy #2
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    Taxonomy Code        |    101YP2500X
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    Taxonomy Name        |    Professional Counselor
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    License Number       |    
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    License Number State |    
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