Provider Demographics
NPI:1821004706
Name:JOHNSTON, REBECCA SINCLAIR (PHD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:SINCLAIR
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 BELMONT ST
Mailing Address - Street 2:SUITE 36
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472-4910
Mailing Address - Country:US
Mailing Address - Phone:617-924-0268
Mailing Address - Fax:
Practice Address - Street 1:550 BELMONT ST
Practice Address - Street 2:SUITE 36
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-4910
Practice Address - Country:US
Practice Address - Phone:617-924-0268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2021-12-29
Deactivation Date:2018-06-01
Deactivation Code:
Reactivation Date:2018-06-06
Provider Licenses
StateLicense IDTaxonomies
MA4889103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist