Provider Demographics
NPI:1467753533
Name:JOHNSTON, ROBERT (MSW, LICSW)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:
Last Name:JOHNSTON
Suffix:
Gender:M
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 RANTOUL ST
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-4240
Mailing Address - Country:US
Mailing Address - Phone:978-921-1293
Mailing Address - Fax:978-921-1294
Practice Address - Street 1:300 BRICKSTONE SQ STE 201
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-1497
Practice Address - Country:US
Practice Address - Phone:978-494-4191
Practice Address - Fax:978-662-5291
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-05
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1031931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical