Provider Demographics
NPI:1376744193
Name:JOHNSTON, FAYE E (LMHC)
Entity Type:Individual
Prefix:MS
First Name:FAYE
Middle Name:E
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:398 CAMINO GARDENS BLVD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-5827
Mailing Address - Country:US
Mailing Address - Phone:561-395-6599
Mailing Address - Fax:561-395-8964
Practice Address - Street 1:398 CAMINO GARDENS BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-5827
Practice Address - Country:US
Practice Address - Phone:561-395-6599
Practice Address - Fax:561-395-8964
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH0004300101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health