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NPI Code Detail

MEDICARE: JASON JOHNSON LCDC

MEDICARE:   JASON  JOHNSON  LCDC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor17356TX

General Provider Information

NPI Number : 1306791074
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASON JOHNSON LCDC
Provider Business Mailing Address
First Line : 7414 E GRAND AVE APT 326
Second Line :
City : DALLAS
State : TX
Zip : 75214-5823
Country : US
Telephone Number : 972-849-4236
Fax Number :
Provider Business Practice Location Address
First Line : 5710 LYNDON B JOHNSON FWY STE 165
Second Line :
City : DALLAS
State : TX
Zip : 75240-6572
Country : US
Telephone Number : 972-849-4236
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2026
Last Update Date : 02/27/2026

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Directions to “ JASON JOHNSON LCDC” Practice Location

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