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NPI Code Detail

MEDICARE: MR. TODD RICHARD JOHNSON MA, LPC

MEDICARE: MR. TODD RICHARD JOHNSON MA, LPC
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
1101YP2500XProfessional Counselor71393TX

General Provider Information

NPI Number : 1326188442
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. TODD RICHARD JOHNSON MA, LPC
Provider Business Mailing Address
First Line : 5007 WING RD
Second Line :
City : AUSTIN
State : TX
Zip : 78749-1629
Country : US
Telephone Number : 509-847-9951
Fax Number :
Provider Business Practice Location Address
First Line : 1600 PAYTON GIN RD
Second Line :
City : AUSTIN
State : TX
Zip : 78758-6506
Country : US
Telephone Number : 512-836-2150
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2007
Last Update Date : 03/11/2014

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