Provider Demographics
NPI:1043761323
Name:JOHNSTON, ERIN SHOCKLEE (LAC, LPC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:SHOCKLEE
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:LAC, LPC
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:SHOCKLEE
Other - Last Name:JOHNSTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC, LPC
Mailing Address - Street 1:2020 E 70TH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-5332
Mailing Address - Country:US
Mailing Address - Phone:318-423-2819
Mailing Address - Fax:
Practice Address - Street 1:2020 E 70TH ST STE 201
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-5332
Practice Address - Country:US
Practice Address - Phone:318-423-2819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-20
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6623101YP2500X
LA1570101YA0400X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health