MEDICARE: JOCELYN MONICA JOHNSON 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
1	101YM0800X	Mental Health Counselor	70567	TX

General Provider Information

NPI Number	:	1366825671
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOCELYN MONICA JOHNSON LPC

Provider Business Mailing Address
First Line	:	6442 PELICAN CORAL
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78244-1679
Country	:	US
Telephone Number	:	210-885-0082
Fax Number	:

Provider Business Practice Location Address
First Line	:	1001 PAT BOOKER RD
Second Line	:	STE 208
City	:	UNIVERSAL CITY
State	:	TX
Zip	:	78148-4154
Country	:	US
Telephone Number	:	210-885-0082
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2015
Last Update Date	:	07/06/2015

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