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General NPI Number Information
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NPI Number | 1144473968
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Entity Type | Individual
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Provider Name | CHRISTINE LYNN JOHNSTON PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 10/23/2008
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Last Update Date | 10/23/2008
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Provider Practice Location Address
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Address Line | 2500 E VAN BUREN ST
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City | PHOENIX
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State | AZ
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Zip | 85008-6037
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Country | US
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Telephone | 602-220-6191
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Fax |
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Provider Business Mailing Address
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Address Line | 2346 W FLOWER ST
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City | PHOENIX
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State | AZ
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Zip | 85015-5644
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Country | US
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Telephone | 602-828-7972
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Fax |
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 10439
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 12449
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 3942
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License Number State | AZ
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