Provider Demographics
NPI:1043405806
Name:JOHNSTON, KARIE MALONEY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KARIE
Middle Name:MALONEY
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:KARIE
Other - Middle Name:JEAN
Other - Last Name:MALONEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:641 E HILLCREST ST
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-2640
Mailing Address - Country:US
Mailing Address - Phone:407-252-5910
Mailing Address - Fax:
Practice Address - Street 1:315 N LAKEMONT AVE
Practice Address - Street 2:STE B
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-3205
Practice Address - Country:US
Practice Address - Phone:407-830-6412
Practice Address - Fax:407-830-8413
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-13
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW71131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical