Provider Demographics
NPI:1326186867
Name:JOHNSTON, RUTH NAOMI (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:NAOMI
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:462 CENTRAL ST
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-4839
Mailing Address - Country:US
Mailing Address - Phone:508-879-0837
Mailing Address - Fax:
Practice Address - Street 1:1 FRANKLIN COMMONS
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-6619
Practice Address - Country:US
Practice Address - Phone:508-872-6610
Practice Address - Fax:508-872-6722
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1031941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP03467OtherBLUE CROSS & BLUE SHIELD
MAP03467Medicare ID - Type Unspecified