Provider Demographics
NPI:1407981780
Name:JOHNSTON, MELANIE JOAN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:JOAN
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 N CAUSEWAY BLVD STE 205
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70448-4660
Mailing Address - Country:US
Mailing Address - Phone:985-674-1399
Mailing Address - Fax:985-626-3252
Practice Address - Street 1:111 N CAUSEWAY BLVD STE 205
Practice Address - Street 2:
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70448-4660
Practice Address - Country:US
Practice Address - Phone:985-674-1399
Practice Address - Fax:985-626-3252
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1776101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1776OtherLICENSED PROFESSIONAL COU