Provider Demographics
NPI:1467086538
Name:JOHNSTON, LAURA BARKLEY (LCSW-A)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:BARKLEY
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:LCSW-A
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:STUART
Other - Last Name:BARKLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW-A
Mailing Address - Street 1:102 MASON FARM RD
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-6134
Mailing Address - Country:US
Mailing Address - Phone:984-974-4478
Mailing Address - Fax:919-843-3413
Practice Address - Street 1:102 MASON FARM RD
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-6134
Practice Address - Country:US
Practice Address - Phone:984-974-4478
Practice Address - Fax:919-843-3413
Is Sole Proprietor?:No
Enumeration Date:2020-02-27
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0119051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical