Provider Demographics
NPI:1093103376
Name:JOHNSTON, ANDREW L (LPC)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:L
Last Name:JOHNSTON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 DELLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29609-5018
Mailing Address - Country:US
Mailing Address - Phone:864-915-1610
Mailing Address - Fax:864-565-7008
Practice Address - Street 1:212 WHITSETT ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-3141
Practice Address - Country:US
Practice Address - Phone:864-990-4442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-08
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6883101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty