Provider Demographics
NPI:1508391434
Name:JOHNSTON, JOHN CADWALLADER (LPCA, CADC III)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:CADWALLADER
Last Name:JOHNSTON
Suffix:
Gender:M
Credentials:LPCA, CADC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:687 CHESHIRE AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-5060
Mailing Address - Country:US
Mailing Address - Phone:541-684-4100
Mailing Address - Fax:541-684-4156
Practice Address - Street 1:687 CHESHIRE AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-5060
Practice Address - Country:US
Practice Address - Phone:541-762-4527
Practice Address - Fax:541-684-4156
Is Sole Proprietor?:No
Enumeration Date:2017-04-28
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR02-03-60101YA0400X
ORR7374101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)