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1538552013 NPI number — AMANDA JO JOHNSTON BS, LAC

NPI Number: 1538552013
Health Care Provider/Practitioner: AMANDA JO JOHNSTON BS, LAC

Information about “1538552013” NPI (AMANDA JO JOHNSTON BS, LAC) exists in 1538552013 in HTML format HTML  |  1538552013 in plain Text format TXT  |  1538552013 in PDF (Portable Document Format) PDF  |  1538552013 in an XML format XML  formats.

NPI Number : 1538552013 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1538552013",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "JOHNSTON",
    "FirstName": "AMANDA",
    "MiddleName": "JO",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "BS, LAC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "WILCOX",
    "OtherFirstName": "AMANDA",
    "OtherMiddleName": "JO",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "BS, LAC",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "1500 14TH ST W STE 290",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "WILLISTON",
    "MailingAddressStateName": "ND",
    "MailingAddressPostalCode": "58801-4078",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "701-751-0299",
    "MailingAddressFaxNumber": "701-713-3299",
    "FirstLinePracticeLocationAddress": "316 2ND AVE W",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WILLISTON",
    "PracticeLocationAddressStateName": "ND",
    "PracticeLocationAddressPostalCode": "58801-5218",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "701-774-4600",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "03/09/2015",
    "LastUpdateDate": "08/13/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "101Y00000X",
          "TaxonomyName": "Counselor",
          "LicenseNumber": "101YA0400X",
          "LicenseNumberStateCode": "MT",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YA0400X",
          "TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
          "LicenseNumber": "1980",
          "LicenseNumberStateCode": "ND",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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