Kelly Johnston, Mary Jaye
Kelly Johnston, Mary Jaye is an sole proprietor health care provider with primary practice located at 355 Linwood , Conroe TX 77304-2007. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Kelly Johnston, Mary Jaye can be contacted via phone (281) 536-6503.Contact Information
Primary practice address
355 Linwood
Conroe TX 77304-2007
Phone: (281) 536-6503
Fax: (936) 447-6985
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Counselor | 101Y00000X | 15145 | Texas |
Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 15145 | Texas |
Profile Details
NPI number | 1881764702 |
---|---|
LBN Legal business name | Kelly Johnston, Mary Jaye |
Credentials | LPC-S |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Nov 8th, 2006 |
Last updated | Oct 2nd, 2013 - about 11 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1881764702 | NPPES |
Texas | MEDICAID | 161320001 |
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