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General NPI Number Information
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NPI Number | 1508974635
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Entity Type | Individual
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Provider Name | EDITH D JOHNSTON LPC
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Gender | Female
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Dates
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Enumeration Date | 08/28/2006
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Last Update Date | 12/15/2016
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Provider Practice Location Address
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Address Line | 800 A ST
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City | DELTA
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State | CO
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Zip | 81416-2627
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Country | US
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Telephone | 970-216-5753
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Fax | 970-874-2840
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Provider Business Mailing Address
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Address Line | P.O. BOX 301
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City | DELTA
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State | CO
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Zip | 81416
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Country | US
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Telephone | 970-216-5753
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Fax | 970-874-2840
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2162
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License Number State | CO
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