1326460973 NPI number — JOHNSON COUNSELING SERVICES, PLLC

Table of content: DR. JASON HAROLD NEUSTADTER M.D. (NPI 1063632461)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326460973 NPI number — JOHNSON COUNSELING SERVICES, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JOHNSON COUNSELING SERVICES, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326460973
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/08/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2601 LITTLE ELM PARKWAY
Provider Second Line Business Mailing Address:
SUITE 801
Provider Business Mailing Address City Name:
LITTLE ELM
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75068
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
317-402-2296
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2601 LITTLE ELM PARKWAY
Provider Second Line Business Practice Location Address:
SUITE 801
Provider Business Practice Location Address City Name:
LITTLE ELM
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75068
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-402-2296
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/16/2014

Additional Information

Authorized Official

Authorized Official Last Name:
JOHNSON
Authorized Official First Name:
MINTA
Authorized Official Middle Name:
Authorized Official Title or Position:
PSYCHOTHERAPIST
Authorized Official Telephone Number:
317-402-2296

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  58540 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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