Johnson, Constance

Johnson, Constance is an sole proprietor health care provider with primary practice located at 601 Pendleton St , Temple TX 76504-2947. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Johnson, Constance can be contacted via phone (254) 742-1524.

Contact Information

Primary practice address
601 Pendleton St Temple TX 76504-2947
Phone: (254) 742-1524
Fax: (254) 742-0789
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 14874 Texas
Behavioral Health & Social Service Providers / Professional 101YP2500X 14874 Texas

Profile Details

NPI number 1306857875
LBN Legal business name Johnson, Constance
Credentials LPC, LPC-SUPERVISOR
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 10th, 2006
Last updated Mar 1st, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306857875 NPPES
Texas Other 26-0191219 PGBA / VALUE OPTIONS TRIC
Texas Other 4067LC PGBA / VALUE OPTIONS TRIC
Texas MEDICAID 028373101 PGBA / VALUE OPTIONS TRIC

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