Provider Demographics
NPI:1619643905
Name:JOHNSTON, JANIE NEMS (LCSW)
Entity Type:Individual
Prefix:
First Name:JANIE
Middle Name:NEMS
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 DORCHESTER RD APT 4K
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-6746
Mailing Address - Country:US
Mailing Address - Phone:347-658-7605
Mailing Address - Fax:
Practice Address - Street 1:1801 DORCHESTER RD APT 4K
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-6746
Practice Address - Country:US
Practice Address - Phone:347-658-7605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-18
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY073033-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical