Provider Demographics
NPI:1780668319
Name:JOHNSTON, DANA LYNNE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:LYNNE
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:DANA
Other - Middle Name:LYNNE
Other - Last Name:FRANCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:289 INDEPENDENCE BLVD
Mailing Address - Street 2:SUITE 221
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-5493
Mailing Address - Country:US
Mailing Address - Phone:757-498-9320
Mailing Address - Fax:757-498-9321
Practice Address - Street 1:289 INDEPENDENCE BLVD
Practice Address - Street 2:SUITE 221
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-5493
Practice Address - Country:US
Practice Address - Phone:757-498-9320
Practice Address - Fax:757-498-9321
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-06
Last Update Date:2015-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040054281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA307780OtherANTHEM
VA1780668319OtherUBH--UNITED BEHAVIORAL HEALTH
VA1780668319Medicaid
VAO803341MOtherOPTIMA
VA341849OtherTRICARE
VA190001977OtherMEDICARE
VA1780668319OtherHEALTHLINK/UNICARE
VA$$$$$$$$$OtherAETNA
VA307780OtherANTHEM