| Deanna Johnston Lpc Pllc | |
|
2809 Earl Rudder Fwy S Ste 207 College Station TX 77845 | |
| (979) 446-8724 | |
| Not Available |
| Full Name | Deanna Johnston Lpc Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2809 Earl Rudder Fwy S Ste 207, College Station, Texas |
| Authorized Official Name and Position | Deanna Johnston (LICENSED PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 9794468724 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Deanna Johnston Lpc Pllc 2809 Earl Rudder Fwy S Ste 207 College Station TX 77845 Ph: (979) 446-8724 | Deanna Johnston Lpc Pllc 2809 Earl Rudder Fwy S Ste 207 College Station TX 77845 Ph: (979) 446-8724 |
| NPI Number | 1245005826 |
|---|---|
| Provider Enumeration Date | 11/23/2023 |
| Last Update Date | 11/23/2023 |
| Certification Date | 11/23/2023 |
| Medicare PECOS PAC ID | 4981054160 |
|---|---|
| Medicare Enrollment ID | O20231229002782 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245005826 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Deanna Johnston |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316429715 PECOS PAC ID: 6709130990 Enrollment ID: I20231218001636 |
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