Provider Demographics
NPI:1750537833
Name:ALISON JOHNSTON LLC
Entity type:Organization
Organization Name:ALISON JOHNSTON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSTON
Authorized Official - Suffix:
Authorized Official - Credentials:ACSW, LCSW
Authorized Official - Phone:985-727-0079
Mailing Address - Street 1:306 JENNY LN
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70448-7017
Mailing Address - Country:US
Mailing Address - Phone:985-727-0079
Mailing Address - Fax:985-727-9699
Practice Address - Street 1:102 VILLAGE ST STE C
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-5354
Practice Address - Country:US
Practice Address - Phone:985-727-0079
Practice Address - Fax:985-727-9699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-08
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3760251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5T913Medicare PIN