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NPI Code Detail

MEDICARE: MS. HOLLY KATHLEEN JOHNSTON LCSW

MEDICARE: MS. HOLLY KATHLEEN JOHNSTON LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker36447TX

General Provider Information

NPI Number : 1275734733
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. HOLLY KATHLEEN JOHNSTON LCSW
Provider Business Mailing Address
First Line : 250 JOHNNYS WAY
Second Line :
City : KYLE
State : TX
Zip : 78640-5667
Country : US
Telephone Number : 512-947-8655
Fax Number : 512-268-4152
Provider Business Practice Location Address
First Line : 601 W 18TH ST
Second Line :
City : AUSTIN
State : TX
Zip : 78701-1111
Country : US
Telephone Number : 512-947-8655
Fax Number : 512-268-4152
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2007
Last Update Date : 07/08/2007

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Directions to “ MS. HOLLY KATHLEEN JOHNSTON LCSW” Practice Location

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