Provider Demographics
NPI:1336304104
Name:JOHNSTON, WILLIAM MARSHALL (MA, LMHC, LCAC)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:MARSHALL
Last Name:JOHNSTON
Suffix:
Gender:M
Credentials:MA, LMHC, LCAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13295 ILLINOIS ST STE 139
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-3020
Mailing Address - Country:US
Mailing Address - Phone:317-900-6109
Mailing Address - Fax:
Practice Address - Street 1:13295 ILLINOIS ST STE 139
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-3020
Practice Address - Country:US
Practice Address - Phone:317-900-6109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-22
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39001990A101Y00000X, 102L00000X, 106H00000X, 101YM0800X
IN87000650A101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist