MEDICARE: MRS. ALYSON ELAINE BRUBAKER JOHNSON LCSW

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	15934	TX
2	1041C0700X	Clinical Social Worker	103940	TX

General Provider Information

NPI Number	:	1922942580
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALYSON ELAINE BRUBAKER JOHNSON LCSW

Provider Business Mailing Address
First Line	:	1400 ROXBORO LN
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75071-7489
Country	:	US
Telephone Number	:	832-317-2156
Fax Number	:	832-317-2156

Provider Business Practice Location Address
First Line	:	13760 NOEL RD STE 332
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75240-7336
Country	:	US
Telephone Number	:	469-949-3636
Fax Number	:

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

Provider Enumeration Date	:	04/15/2026
Last Update Date	:	04/15/2026

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