Healthcare Provider Details

I. General information

NPI: 1740447556
Provider Name (Legal Business Name): JOSEPH CARTER JOHNSTON II LPC-MHSP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JODY C JOHNSTON LPC-MHSP

II. Dates (important events)

Enumeration Date: 05/20/2008
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

134 RURITAN RD # 52
FALL BRANCH TN
37656-1851
US

IV. Provider business mailing address

134 RURITAN RD # 52
FALL BRANCH TN
37656-1851
US

V. Phone/Fax

Practice location:
  • Phone: 423-943-5550
  • Fax:
Mailing address:
  • Phone: 423-943-5550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2303
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2303
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: