Provider Demographics
NPI:1508555194
Name:JOHNSTON, ALEXANDRA (MSED)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 MONTICELLO AVE
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-2834
Mailing Address - Country:US
Mailing Address - Phone:757-503-7917
Mailing Address - Fax:855-823-3243
Practice Address - Street 1:6464 HAMPTON BLVD
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23508-1210
Practice Address - Country:US
Practice Address - Phone:757-503-7917
Practice Address - Fax:855-823-3243
Is Sole Proprietor?:No
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional