Provider Demographics
NPI:1073871828
Name:JOHNSTON, BRIANNA (LMFT)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:BRIANNA
Other - Middle Name:
Other - Last Name:DEXTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:1918 WINDY HILL CT S
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47905-5582
Mailing Address - Country:US
Mailing Address - Phone:765-250-6246
Mailing Address - Fax:
Practice Address - Street 1:100 SAW MILL RD STE 3200
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905-5597
Practice Address - Country:US
Practice Address - Phone:765-250-6246
Practice Address - Fax:765-374-0865
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-30
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN35001894A106H00000X, 106H00000X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist