Provider Demographics
NPI:1477669463
Name:JOHNSTON, STEVEN LAIRD (MA)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:LAIRD
Last Name:JOHNSTON
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1308 EAGLE VIEW DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43228-6442
Mailing Address - Country:US
Mailing Address - Phone:614-306-8895
Mailing Address - Fax:
Practice Address - Street 1:5000 SUNBURY RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43230-1136
Practice Address - Country:US
Practice Address - Phone:614-337-1986
Practice Address - Fax:614-337-2936
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0002472101YP2500X
OHE-0002472101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2980332Medicaid
OH31-1074038OtherTAX ID