Johnston, Roy Alan

Johnston, Roy Alan is an individual health care provider with primary practice located at 4041 N. Central Ave Building C, Phoenix AZ 85012-3133. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Johnston, Roy Alan can be contacted via phone (602) 279-5262.

Contact Information

Primary practice address
4041 N. Central Ave Building C Phoenix AZ 85012-3133
Phone: (602) 279-5262
Fax: (602) 279-5390
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X LISAC11403 Arizona
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X LISAC-11403 Arizona

Profile Details

NPI number 1760681985
LBN Legal business name Johnston, Roy Alan
Credentials L.I.S.A.C
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 17th, 2007
Last updated Sep 5th, 2014 - about 11 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 1760681985 NPPES
Arizona MEDICAID 910217

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