Provider Demographics
NPI:1942796149
Name:JOHNSTON, HANNAH FALLS (LICSW, PIP)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:FALLS
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:LICSW, PIP
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:FALLS
Other - Last Name:JOHNSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:2141 LEGACY PARK LOOP
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35404-5231
Mailing Address - Country:US
Mailing Address - Phone:865-209-3786
Mailing Address - Fax:
Practice Address - Street 1:2141 LEGACY PARK LOOP
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35404-5231
Practice Address - Country:US
Practice Address - Phone:865-209-3786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-11
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
TNLSW00000067541041C0700X
AL4357C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health