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General NPI Number Information
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NPI Number | 1588457626
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Entity Type | Individual
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Provider Name | WILLIAM JOHNSTON PSYD
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Gender | Male
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Dates
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Enumeration Date | 05/22/2025
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Last Update Date | 06/27/2025
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Provider Practice Location Address
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Address Line | 316 WARREN AVE
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City | FRONT ROYAL
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State | VA
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Zip | 22630-4483
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Country | US
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Telephone | 202-670-2407
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Fax |
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Provider Business Mailing Address
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Address Line | NORTHWEST REGISTERED AGENT LLC 8401 MAYLAND DRIVE STE A
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City | RICHMOND
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State | VA
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Zip | 23294-4483
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Country | US
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Telephone | 202-670-2407
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0805002661
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License Number State | VA
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