Active NPI
Nicole Johnson
- Professional Counselor
- Venus, TX
National Provider Identifier
1710492152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 90574
- Practice address
- 7526 Wild Mint TRL
Venus, TX 76084-3990 - Phone
- (318) 581-2319
- NPI assigned
- Dec 7, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 90574 | TX | Primary |
Addresses
Primary practice location
7526 Wild Mint TRL
Venus, TX 76084-3990
Mailing address
7526 Wild Mint TRL
Venus, TX 76084-3990
Phone (318) 581-2319
Other practice location 1
100 Hazel St Apt 210
Natchitoches, LA 71457-2638
Phone (318) 581-0265
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
| License | State | Type | Specialty |
|---|---|---|---|
| 90574 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1512604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739059200000",
"number": "1710492152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7526 WILD MINT TRL",
"city": "VENUS",
"state": "TX",
"postal_code": "760843990",
"telephone_number": "318-581-2319"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7526 WILD MINT TRL",
"city": "VENUS",
"state": "TX",
"postal_code": "760843990",
"telephone_number": "318-581-2319"
}
],
"practiceLocations": [
{
"address_1": "100 Hazel St Apt 210",
"address_purpose": "LOCATION",
"city": "Natchitoches",
"state": "LA",
"postal_code": "714572638",
"country_code": "US",
"telephone_number": "318-581-0265",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "NICOLE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-12-07",
"last_updated": "2025-02-09",
"certification_date": "2025-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "90574",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Venus, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.