Individual provider Active NPI

Angelou Deshun Johnson

  • Professional Counselor
  • Dallas, TX
National Provider Identifier
1992227623
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
74337 Issued in TX
Practice address
1707 N Hall St Apt 485
Dallas, TX 75204-4275
Phone
(214) 536-0598
NPI assigned
Jul 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 74337 TX
Professional Counselor 101YP2500X 74337 TX Primary

Addresses

Primary practice location

1707 N Hall St Apt 485
Dallas, TX 75204-4275

Mailing address

1707 N Hall St Apt 485
Dallas, TX 75204-4275
Phone (214) 561-7447

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250812003029 TX Practitioner - Clinical Social Worker 5991203523 Reassigns benefits to 1 organization
I20250829000284 TX Practitioner - Mental Health Counselor 5991203523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

6101 W Plano Pkwy
Suite 230
Plano, TX 75093-8373

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
74337TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Leadher Well LLC Professional Current Accepting new patients
Connections Wellness Group CurrentSince May 31, 2025 Accepting new patients
Connections Physicians Group PastSince Oct 3, 2025 Accepting new patients

Locations

4907 S Collins St
Ste 121
Arlington, TX 76018
Phone (817) 417-9001

1900 Matlock Rd
Bldg 2
Mansfield, TX 76063
Phone (817) 312-6458

6101 W Plano Pkwy
Ste 230
Plano, TX 75093
Phone (469) 613-3390

6101 W Plano Pkwy
Ste 240
Plano, TX 75093
Phone (469) 312-2107

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1499990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1992227623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1707 N HALL ST APT 485",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752044275",
            "telephone_number": "214-561-7447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 N HALL ST APT 485",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752044275",
            "telephone_number": "214-536-0598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ANGELOU",
        "middle_name": "DESHUN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-14",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "74337",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "74337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.