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General NPI Number Information
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NPI Number | 1003263229
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Entity Type | Individual
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Provider Name | LYNDI JOHNSTON MA, LPC
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Gender | Female
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Dates
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Enumeration Date | 05/17/2016
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Last Update Date | 05/05/2021
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Provider Practice Location Address
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Address Line | 7650 2ND AVE STE 108
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City | DETROIT
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State | MI
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Zip | 48202-2412
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Country | US
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Telephone | 313-329-9712
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Fax | 313-879-6812
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Provider Business Mailing Address
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Address Line | 7650 2ND AVE STE 108
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City | DETROIT
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State | MI
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Zip | 48202-2412
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Country | US
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Telephone | 313-329-9712
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Fax | 313-879-6812
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 6401015857
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License Number State | MI
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