Provider Demographics
NPI:1417012915
Name:JOHNSTON, ALISON FIFORD (LCSW,ACSW)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:FIFORD
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:LCSW,ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15049 SW 35TH ST
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33331-2723
Mailing Address - Country:US
Mailing Address - Phone:954-382-2176
Mailing Address - Fax:954-382-2916
Practice Address - Street 1:15049 SW 35TH ST
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33331-2723
Practice Address - Country:US
Practice Address - Phone:954-382-2176
Practice Address - Fax:954-382-2916
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL22241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ3814Medicare ID - Type Unspecified