Individual provider Active NPI

Tiffany Laine Johnson, LAC, LCDC

  • Addiction (Substance Use Disorder) Counselor
  • Humble, TX
National Provider Identifier
1124229752
Registry record updated Sep 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
12266 Issued in TX
Practice address
19333 Highway 59 N
Suite 280
Humble, TX 77338-4204
Phone
(281) 540-0331
Fax
(281) 540-0339
NPI assigned
May 30, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1227 LA
Addiction (Substance Use Disorder) Counselor 101YA0400X 12266 TX Primary

Addresses

Primary practice location

19333 Highway 59 N
Suite 280
Humble, TX 77338-4204

Mailing address

19333 Highway 59 N
Suite 280
Humble, TX 77338-4204
Phone (281) 540-0331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12266TXMDAddiction (Substance Use Disorder) Counselor
1227LAMDClinical Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378425600000",
    "number": "1124229752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19333 HIGHWAY 59 N",
            "address_2": "SUITE 280",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773384204",
            "telephone_number": "281-540-0331",
            "fax_number": "281-540-0339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19333 HIGHWAY 59 N",
            "address_2": "SUITE 280",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773384204",
            "telephone_number": "281-540-0331",
            "fax_number": "281-540-0339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TIFFANY",
        "middle_name": "LAINE",
        "name_prefix": "Mrs.",
        "credential": "LAC, LCDC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-30",
        "last_updated": "2013-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "LA",
            "license": "1227",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "12266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Humble, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.