Provider Demographics
NPI:1891986519
Name:JOHNSTON, ANDREW WEBSTER (CSW)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:WEBSTER
Last Name:JOHNSTON
Suffix:
Gender:M
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 S 200 E
Mailing Address - Street 2:SUITE 308
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84111-3835
Mailing Address - Country:US
Mailing Address - Phone:801-355-3846
Mailing Address - Fax:
Practice Address - Street 1:660 S 200 E
Practice Address - Street 2:SUITE 308
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84111-3835
Practice Address - Country:US
Practice Address - Phone:801-355-3846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6620094-3502104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker