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General NPI Number Information
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NPI Number | 1932670940
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Entity Type | Individual
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Provider Name | ELLEN ROSE JOHNSON LPC
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Gender | Female
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Dates
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Enumeration Date | 12/17/2018
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Last Update Date | 12/18/2018
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Provider Practice Location Address
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Address Line | 5909 WEST LOOP S STE 640
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City | BELLAIRE
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State | TX
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Zip | 77401-2430
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Country | US
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Telephone | 346-320-3195
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Fax |
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Provider Business Mailing Address
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Address Line | 15100 ELLA BLVD APT 1109
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City | HOUSTON
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State | TX
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Zip | 77090-7035
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Country | US
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Telephone | 320-360-7496
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 77739
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License Number State | TX
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