Provider Demographics
NPI:1649221797
Name:JOHNSTON, CAMILLE T (LPC)
Entity Type:Individual
Prefix:
First Name:CAMILLE
Middle Name:T
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1054 S FORT HOOD ST
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76541-7437
Mailing Address - Country:US
Mailing Address - Phone:254-953-3231
Mailing Address - Fax:254-953-3236
Practice Address - Street 1:1054 S FORT HOOD ST
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76541-7437
Practice Address - Country:US
Practice Address - Phone:254-953-3231
Practice Address - Fax:254-953-3236
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14613101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional