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General NPI Number Information
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NPI Number | 1366836272
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Entity Type | Individual
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Provider Name | SOMMERVILLE JOHNSTON LMHC
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Gender | Female
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Dates
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Enumeration Date | 03/28/2015
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Last Update Date | 07/10/2020
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Provider Practice Location Address
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Address Line | 3613 6TH AVE S
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City | BIRMINGHAM
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State | AL
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Zip | 35222-2407
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Country | US
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Telephone | 828-808-7858
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Fax |
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Provider Business Mailing Address
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Address Line | 3212 E BRIARCLIFF RD
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City | MOUNTAIN BRK
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State | AL
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Zip | 35223-1329
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Country | US
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Telephone | 828-808-7858
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 4272
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 9133
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License Number State | NC
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