Provider Demographics
NPI:1164551750
Name:JOHNSTON, LAURA C (LADC1, LMHC)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:C
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:LADC1, LMHC
Other - Prefix:MISS
Other - First Name:LAURA
Other - Middle Name:C
Other - Last Name:HAGGIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCADC, LPC
Mailing Address - Street 1:PO BOX 1248
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02048-5248
Mailing Address - Country:US
Mailing Address - Phone:508-802-4199
Mailing Address - Fax:508-321-9428
Practice Address - Street 1:1133 PLEASANT ST STE A
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02324-2214
Practice Address - Country:US
Practice Address - Phone:508-802-4199
Practice Address - Fax:508-321-9428
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2020-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2366101YA0400X
MA8154101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)