Individual provider Active NPI

Carrie Johnson

  • Mental Health Counselor
  • Houston, TX
National Provider Identifier
1164139440
Registry record updated Nov 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
73839 Issued in TX
Practice address
8311 Fawn Terrace Dr
Houston, TX 77071-3655
Phone
(832) 545-1906
NPI assigned
Nov 4, 2022
Last updated
Nov 4, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 73839 TX Primary

Addresses

Primary practice location

8311 Fawn Terrace Dr
Houston, TX 77071-3655

Mailing address

8311 Fawn Terrace Dr
Houston, TX 77071-3655
Phone (832) 545-1906

Other practice location 1

44113 Austin Branch Rd
Hempstead, TX 77445-8336
Phone (979) 921-0736

Other names 1

  • Carrie Lane Johnson Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260618002422 TX Practitioner - Mental Health Counselor 9133691322 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

535 Mack Ave
Kingsley, MI 49649-9220

8311 Fawn Terrace Dr
Houston, TX 77071-3655

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
73839TXMDMental Health Counselor

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1667520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667520000000",
    "number": "1164139440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8311 FAWN TERRACE DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770713655",
            "telephone_number": "832-545-1906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8311 FAWN TERRACE DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770713655",
            "telephone_number": "832-545-1906"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44113 Austin Branch Rd",
            "address_purpose": "LOCATION",
            "city": "Hempstead",
            "state": "TX",
            "postal_code": "774458336",
            "country_code": "US",
            "telephone_number": "979-921-0736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CARRIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-04",
        "last_updated": "2022-11-04",
        "certification_date": "2022-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "73839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARRIE",
            "last_name": "JOHNSON",
            "middle_name": "LANE",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.