Provider Demographics
NPI:1497508865
Name:JOHNSTON, LAURIE CHRISTINE (LMSW)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:CHRISTINE
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2790 STENZEL AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-1008
Mailing Address - Country:US
Mailing Address - Phone:716-531-2169
Mailing Address - Fax:
Practice Address - Street 1:8205 MAIN ST STE 14
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-6054
Practice Address - Country:US
Practice Address - Phone:716-531-2169
Practice Address - Fax:716-529-0052
Is Sole Proprietor?:No
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY076332104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker