Healthcare Provider Details

I. General information

NPI: 1720011604
Provider Name (Legal Business Name): JAMES MARION JOHNSTON LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 02/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

529 COUNTRY CLUB RD
BREVARD NC
28712-4011
US

IV. Provider business mailing address

299 FAIRVIEW RD
ASHEVILLE NC
28803
US

V. Phone/Fax

Practice location:
  • Phone: 828-883-9676
  • Fax: 828-884-9753
Mailing address:
  • Phone: 828-545-5467
  • Fax: 828-692-7710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number893
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: