Provider Demographics
NPI:1740405976
Name:JOHNSTON, S ELAINE (PHD LPC)
Entity Type:Individual
Prefix:DR
First Name:S
Middle Name:ELAINE
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:PHD LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 962
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-0962
Mailing Address - Country:US
Mailing Address - Phone:469-964-6957
Mailing Address - Fax:972-698-8479
Practice Address - Street 1:3080 W HIGHWAY 287 BYP
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75167-5000
Practice Address - Country:US
Practice Address - Phone:469-964-6957
Practice Address - Fax:972-698-8479
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-14
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX58987170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS