Johnston, Mary M

Johnston, Mary M is an sole proprietor health care provider with primary practice located at 2113 State St 1St Floor, New Albany IN 47150-4961. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Johnston, Mary M can be contacted via phone (812) 949-3505.

Contact Information

Primary practice address
2113 State St 1St Floor New Albany IN 47150-4961
Phone: (812) 949-3505
Fax: (812) 949-3505
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 3380 Kentucky
Behavioral Health & Social Service Providers / Clinical 1041C0700X 34004819A Indiana

Profile Details

NPI number 1689690471
LBN Legal business name Johnston, Mary M
Credentials LSCW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 14th, 2006
Last updated Feb 21st, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689690471 NPPES
Indiana MEDICAID 200189820A

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