Provider Demographics
NPI:1689995680
Name:JOHNSTON, WENDY ANGELINA (LCSW-C)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:ANGELINA
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:442 5TH AVE # 1983
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-2794
Mailing Address - Country:US
Mailing Address - Phone:253-648-0340
Mailing Address - Fax:206-673-8050
Practice Address - Street 1:4445 WILLARD AVE STE 600
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-3786
Practice Address - Country:US
Practice Address - Phone:212-564-0480
Practice Address - Fax:833-450-0817
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-14
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD158901041C0700X
NY0971551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical