Kelly Johnston, Mary Jaye

Kelly Johnston, Mary Jaye is an sole proprietor health care provider with primary practice located at 355 Linwood , Conroe TX 77304-2007. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Kelly Johnston, Mary Jaye can be contacted via phone (281) 536-6503.

Contact Information

Primary practice address
355 Linwood Conroe TX 77304-2007
Phone: (281) 536-6503
Fax: (936) 447-6985
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X 15145 Texas
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 15145 Texas

Profile Details

NPI number 1881764702
LBN Legal business name Kelly Johnston, Mary Jaye
Credentials LPC-S
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 8th, 2006
Last updated Oct 2nd, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881764702 NPPES
Texas MEDICAID 161320001

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