Healthcare Provider Details

I. General information

NPI: 1629997234
Provider Name (Legal Business Name): ELIZABETH R JOHNSTON-SMITH APC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1740 GRASSLAND PKWY UNIT 106
ALPHARETTA GA
30004-4736
US

IV. Provider business mailing address

3111 CENTURION DR
GAINESVILLE GA
30506-7215
US

V. Phone/Fax

Practice location:
  • Phone: 770-561-9231
  • Fax:
Mailing address:
  • Phone: 770-561-9231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAPC011221
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberAPC011221
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: