Provider Demographics
NPI:1457627598
Name:CHRISTOPHER L. JOHNSTON,PH.D.
Entity Type:Organization
Organization Name:CHRISTOPHER L. JOHNSTON,PH.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR/PSYCHOLOGICAL CONSULTANT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:JOHNSTON
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:847-835-7242
Mailing Address - Street 1:706 GREEN BAY RD
Mailing Address - Street 2:SUITE3
Mailing Address - City:GLENCOE
Mailing Address - State:IL
Mailing Address - Zip Code:60022-1590
Mailing Address - Country:US
Mailing Address - Phone:847-835-7242
Mailing Address - Fax:
Practice Address - Street 1:706 GREEN BAY RD
Practice Address - Street 2:SUITE3
Practice Address - City:GLENCOE
Practice Address - State:IL
Practice Address - Zip Code:60022-1590
Practice Address - Country:US
Practice Address - Phone:847-835-7242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-22
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180004094101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty