Provider Demographics
NPI:1033419734
Name:JOHNSTON, CATHERINE ANN (LCSW)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ANN
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:ANN
Other - Last Name:LEAHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PLCSW
Mailing Address - Street 1:201 W BROADWAY STE 3I
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-3842
Mailing Address - Country:US
Mailing Address - Phone:573-214-0436
Mailing Address - Fax:573-442-0606
Practice Address - Street 1:201 W BROADWAY STE 3I
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-3842
Practice Address - Country:US
Practice Address - Phone:573-214-0436
Practice Address - Fax:573-442-0606
Is Sole Proprietor?:No
Enumeration Date:2010-10-27
Last Update Date:2015-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20110210631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical