MEDICARE: DANNY WAYNE 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	101YA0400X	Addiction (Substance Use Disorder) Counselor	16782	TX
2	101YM0800X	Mental Health Counselor	16782	TX
3	101YP2500X	Professional Counselor	16782	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932364502
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANNY WAYNE JOHNSON LPC

Provider Business Mailing Address
First Line	:	21811 KATY FWY STE D110
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77450-1813
Country	:	US
Telephone Number	:	713-632-5237
Fax Number	:

Provider Business Practice Location Address
First Line	:	21811 KATY FWY STE D110
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77450-1813
Country	:	US
Telephone Number	:	713-632-5237
Fax Number	:

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

Provider Enumeration Date	:	07/23/2008
Last Update Date	:	07/23/2008

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